Waiver

Firearms Safety Rules

 

  1. Muzzle Management: Always keep your muzzle pointed in a safe direction (initials): __________

 

  1. Trigger Finger Discipline: Always keep your finger off the trigger until you are on target and ready to fire (initials): __________

 

  1. Know the status of your firearm/s (initials): __________

 

  1. Identify your target and what is around it (initials): __________

 

  1. Ear protection and wrap around eye protection are required to be worn at all times while firing (initials): __________

 

  1. When clearing firearms, always check both visually and physically to see that it is unloaded (initials): __________

 

  1. Follow any additional specific safety guidance provided by instructors and range staff (initials): __________

 

  1. You are expected to use good judgement, and to refrain from attempting any exercise, which you may not be able to perform safely, based upon your own ability, equipment, prior training or physical condition (initials): __________

 

  1. Remember: Everyone has the responsibility for range safety (initials): __________

 

 

Do you have any physical disability, limitation, illness or other condition that would affect your ability to participate safely in any aspect of this program?   ☐Yes   ☐ No  (Initials) __________

 

Are you under the influence of any prescription/non-prescription drug or alcohol that would influence your safe participation in any aspect of this program?   ☐Yes   ☐ No  (Initials) __________

I HAVE READ AND UNDERSTAND THE RANGE SAFETY TULES AND REGULATIONS. I ACKNOWLEDGE THAT AT ANY POINT IN TIME VERITAC MAY REMOVE ME FROM CLASS OR AN EVENT IF I EXHIBIT UNSAFE BEHAVIOUR OR PRESET A SAFETY RISK (initials): __________.

 

Signature:   _________________________________________   Date:   ___________________

 

Print Name: ___________________________________________________________________

 

 

General Release of Liability and Assumption of Risk

 

I, _______________________________________________ of _________________________________________,

                                (print full name)                                                             (print place of residence)

On behalf of my successors, assigns, heirs and executors, do hereby acknowledge, release, covenant not to sue, and forever discharge Veritac Solutions Inc of 3291 Merlin Road, Victoria, BC, its employees, agents, successors, and assigns, of and from any and all manner of action and actions, claims, suits, damages, judgements and demands of any kind whatsoever, whether now or in the future, at law or inequity, that results or may result from firearms or subject control procedures used upon the premises of (including its hosting club and/or agency) or from any training or instruction on the use of such firearms and subject control procedures by Veritac Solutions Inc, its successors, employees, agents and assigns.

I further acknowledge that the use of firearms is an inherently dangerous activity and assume the risks of using and employing firearms, related products or subject control procedures on the premises of Veritac Solutions Inc or its host club and/or agency.

I further acknowledge that the study and application of firearms techniques and subject control procedures is physically demanding and requires that I be in good physical condition, and free of any disability or physical condition that would affect my participationg.

I further acknowledge that my successful completion of any course with Veritac Solutions Inc does not allow me to represent myself as a Veritac Solutions instructor or represent myself as an employee of Veritac Solutions or allow me to utilize the Veritac Solutions Course certification without written consent.

I further acknowledge and consent to having photograph/videograph taken while participating in Veritac Solutions courses/events. These pictures may be displayed in any and all our publications, including but not limited to newsletters, the website, brochures, advertisements, and displayed within any media source (including video). Consent is hereby given for unlimited media use without compensation, monetary or otherwise. *Current Law Enforcement Officers and Military can request reasonable anonymity (no facial depictions).

I further acknowledge that I have read and understood the forgoing RELEASE OF LIABILITY and ASSUMPTION OF RISK.

This Waiver will be construed in accordance with and governed by the laws of the Province of British Columbia and by the Country of Canada.

IN WITNESS WHEREOF the Participant and Witness has duly affixed their signatures under hand and seal on this _____ day of _____________, 20____.

Participant: __________________________________    Witness: ______________________________________

                                           (sign name)                                                                      (witness signature)

 

EMERGENCY CONTACT INFORMATION      NAME:______________________     PHONE:_____________________