1 Wilshire Gun Liability Release Form To be completed by all

Wilshire Gun Liability Release Form
To be completed by all persons entering any Wilshire Gun Range
Name (exactly as appears on ID) __________________________________________________________________
Address: ____________________________________City:__________________________ State: ____ Zip: _______
ID Type/Number________________________________________ Issuing State______ Exp Date_______________
Date of Birth ______________________ Email _______________________________________________________
(If under the age of 21, you must be accompanied by a parent or legal guardian; waiver required of all parties)
Phone: (____)_______________________ May we text Wilshire Gun specials to you? Yes No
Email Address: ________________________________________
Please circle your answer to each of the following questions:
Is this your first time shooting a handgun/rifle/shotgun? Yes No
Are you under 21 years of age? If yes, must be accompanied by a parent or legal guardian. Yes No
Are you a fugitive from justice? Yes No
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant or narcotic drug or
any other controlled substance? Yes No
Have you been convicted in any court of a crime punishable by imprisonment for a term exceeding one
year, even if you were given a shorter sentence? Yes No
Have you been adjudicated as mentally defective or have you ever been committed to a mental
institution? Yes No
Have you been convicted in any court of a misdemeanor crime of domestic violence? Yes No
Are you subject to a court order restraining you from harassing, stalking or threatening an intimate
partner or child of such partner? Yes No
WAIVER, RELEASE OF LIABILITY AND INDEMNITY AGREEMENT
In consideration of the undersigned being permitted to engage in any activity, recreational or otherwise, on any
property, including without limitation any building, structure, parking areas, sidewalks and land, leased, occupied, used
or accessed by Wilshire Gun, LLC, Wilshire Shooting Sports, LLC, d/b/a The Range Café and d/b/a Wilshire Gun, Cold
Hand Arms, LLC or Oklahoma Machine Guns, LLC, and each of their successors and assigns and owned by Wilshire
Alliance, LLC or any of its successors and assigns, including without limitation the property located at 521 and 615 W.
Wilshire Blvd., Oklahoma City, Oklahoma 73116, (collectively the “Premises”), the undersigned and the undersigned’s
heirs, family members, guests, executors, administrators, personal representatives, successors and assigns (collectively
the “Undersigned”) hereby understands, acknowledges and agrees to the following:
1. The Undersigned is fully aware of the risks and hazards inherent, whether known or unknown, in entering upon
and taking part in any activity on the Premises and voluntarily enters and takes part in any activity on the Premises with
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the knowledge and appreciation of the dangers involved; further, the Undersigned expressly assumes the risk of
entering on the Premises and taking part in any activity, recreational or otherwise, on the Premises, including without
limitation: archery; handgun, machine gun, rifle and shotgun shooting; firing live ammunition; observing individuals
discharging firearms or other types of weapons; eating food or drinking beverages, including any type of alcoholic
beverage; parking; and any other use of or activity on the Premises.
2. The Undersigned hereby releases, waives, and forever discharges and covenants not to sue or make a claim
against Wilshire Gun, LLC, Wilshire Shooting Sports, LLC, d/b/a The Range Café and d/b/a Wilshire Gun, Cold Hand Arms,
LLC, Oklahoma Machine Guns, LLC or Wilshire Alliance, LLC including each of their respective affiliates, successors and
assigns, officers, managers, volunteers, members, directors, employees, agents, attorneys or representatives,
(collectively, the “Wilshire Gun Releasees”) for any and all claims, demands, damages, expenses, causes of action,
attachments of property or liability of any kind whatsoever that arise, directly or indirectly from property damage,
personal or emotional injury, including partial or total disability, dismemberment or paralysis, or death directly or
indirectly resulting from the Undersigned entering or being on the Premises, even if such claims demands, damages,
expenses, causes of action, attachments of property or liability result partially or wholly, or directly or indirectly, from
any act or omission to act, whether negligent or otherwise, including negligent or omitted first-aid operations or
procedures, by Wilshire Gun Releasees.
3. The Undersigned certifies that he/she is not prohibited under any Federal or State law from possessing a
firearm.
4. The Undersigned acknowledges that the risks and hazards that he/she is assuming may increase or change
during the Agreement Term.
5. The Undersigned hereby consents to and authorizes the administration of all emergency medical treatment, or
lack thereof, which might be provided or available at the Premises.
6. The Undersigned acknowledges and agrees that he/she/they have read and understands and at all times will
abide by all rules and regulations, any rules or procedures applicable to any particular activity, the procedures, safety
rules and any and all instructions whether communicated in writing or verbally with respect to the Premises which are
incorporated herein by reference, including those rules and regulations attached hereto and incorporated herein, (the
“Rules”).
7. The Undersigned agrees to indemnify, hold harmless and defend the Wilshire Gun Releasees from any and all
fault, liabilities, costs (including costs of any settlement or judgment, costs of court and attorneys fees), expenses, claims
demands and lawsuits directly or indirectly arising out of, related to or connected with the actions or omissions of the
Undersigned occurring on the Premises
8. The Undersigned acknowledges and agrees that this Waiver, Release of Liability and Indemnity Agreement shall
be interpreted and enforced under the laws of the State of Oklahoma. The Undersigned hereby expressly understands,
acknowledges and agrees that this Waiver, Release of Liability and Indemnity Agreement is intended to be as broad and
inclusive as is permitted by the laws of the State of Oklahoma.
9. The Undersigned acknowledges and agrees that this Waiver, Release of Liability and Indemnity Agreement shall
be in full force and effective for a period of time commencing on the date executed and ending on last calendar day of
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the twelfth (12th) calendar month thereafter, (the “Agreement Term”); for the avoidance of doubt, during the
Agreement Term this Waiver, Release of Liability and Indemnity Agreement shall be applicable to each and every
occasion that the Undersigned enters on to the Premises.
10. The Undersigned acknowledges and agrees that if any provision of this Waiver, Release of Liability and
Indemnity Agreement is held to be invalid, void or otherwise unenforceable, the parties hereto intend that such
provision or portion shall remain applicable to the fullest extent permitted by law, and the remaining provisions or
portion shall continue and remain in full force and effect.
11. The Undersigned acknowledges and agrees that Sections 1,2,7,8 and 10 shall survive the termination of this
Waiver, Release of Liability and Indemnity Agreement.
THE UNDERSIGNED ENTERS INTO THIS WAIVER, RELEASE OF LIABILITY AND INDEMNITY AGREEMENT
WILLINGLY AND VOLUNTARILY, AND UNDERSTANDS THAT BY THIS SIGNATURE THE UNDERSIGNED ASSUMES RISKS
AND WAIVES SUBSTANTIAL RIGHTS, AGREEING NOT TO SUE ANY WILSHIRE GUN RELEASEE AND TO RELEASE AND
HOLD EACH WILSHIRE GUN RELEASEE HARMLESS FROM LIABILITY. ADDITIONALLY, FOR ANYONE UNDER THE AGE OF
21 YEARS, THIS WAIVER, RELEASE OF LIABILITY AND INDEMNITY AGREEMENT MUST BE SIGNED BY A PARENT OR
LEGAL GUARDIAN WHO IS PRESENT TO ACCOMPANY THE MINOR WHILE SHOOTING ANY TYPE OF WEAPON.
Please initial here __________ if Wilshire Gun may keep your Waiver Release of Liability and Indemnification Agreement
on file for one year from the date below.
Dated this ___ day of ______________________, 20__.
If Undersigned is a Minor:
_____________________________
Signature
_________________________________
Signature of Parent or Guardian
_____________________________
Print Name
_________________________________
Print Name of Parent or Legal Guardian
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