Please complete this waiver & safety packet before shooting. It takes about 3 minutes.
WAIVER OF LIABILITY RELEASE, HOLD HARMLESS AND INDEMNIFICATION AGREEMENT. I wish to engage in firearms shooting at Lost Dutchman Sporting Clays, LLC (LDSC), 20 North Start Road, Eloy, AZ 85132. I understand that engaging in these activities may be hazardous, with accompanying risks of personal injury, death, and/or loss or damage to my property. In consideration of my participation in such shooting activities, I, on my own behalf and that of my heirs, successors, representatives, administrators and assigns, hereby:
Anyone who uses a firearm has a responsibility to themselves and others to use the firearm safely. I acknowledge that I am familiar with the basic rules of firearm safety and that those basic rules have been explained to me. I agree to always follow all the basic rules of firearm safety during my use and handling of any firearms.
I affirm that I have read the range rules and the firearm safety rules above and fully understand that if at any time I fail to follow these safety rules, club rules, or the direction from the range officers, my privilege to these facilities may be denied. I certify that I am over eighteen (18) years of age, or have a parent/legal guardian co-signing below, and have read and understand this Waiver of Liability and have executed this instrument voluntarily on this date. You have the right to refuse this form, and LDSC has the right to refuse to let you participate if you do not sign this form.
All shooters must read, understand, and comply with the following range safety rules, policies, and procedures before shooting at the Lost Dutchman Sporting Clays range.
Safety is everyone's responsibility.
Acknowledgement of wildlife and mining activity:
Your signature below applies to all three documents above (Waiver of Liability, Club Rules, and Environmental Acknowledgement).