Firearm Waiver Template · Sample
Liability Release, Assumption of Risk & Range Rules Acknowledgment
Customize the highlighted sections to your range / FFL before deploying. Not legal advice. Review with counsel.
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1. Signer information
Full legal name
Date of birth
Address (street, city, state, ZIP)
Phone
2. The 4 Rules of Firearm Safety
Initial each rule below. By initialing, you affirm that you understand and agree to follow this rule at all times while on the property.
Treat every firearm as if it were loaded.
Never let the muzzle cover anything you are not willing to destroy.
Keep your finger off the trigger until your sights are on the target.
Be sure of your target and what is beyond it.
3. Intoxication attestation
I attest I am not under the influence of alcohol, drugs, or any other impairing substance, and I will not consume any while on the range.
4. Prohibited-person attestation (NICS-style)
Answer truthfully. Any “Yes” answer requires you to speak with staff before using the range.
Have you ever been convicted of a felony, or any other crime for which the judge could have imprisoned you for more than one year?
Are you a fugitive from justice?
Are you an unlawful user of, or addicted to, any controlled substance?
Have you ever been adjudicated as a mental defective or been committed to a mental institution?
Are you an alien illegally or unlawfully in the United States?
Have you been discharged from the Armed Forces under dishonorable conditions?
Are you subject to a court order restraining you from harassing, stalking, or threatening an intimate partner or child?
Have you ever been convicted in any court of a misdemeanor crime of domestic violence?
5. Range rules acknowledgment
[Customize this section with your range's house rules — typical items include eye and ear protection, holstering policy, lane reservation rules, allowed ammunition, targets, and cleanup expectations.]
I have read and understood the range rules above, and I agree to follow them at all times while on the property.
6. Skill-level self-assessment
New shooter — first time at a range
Some experience — fewer than 10 range visits
Experienced — regular shooter
Instructor / range officer / professional
7. Assumption of risk and release of liability
The use of firearms involves inherent risks of injury and death, including but not limited to gunshot wounds, hearing damage, eye injury, slip-and-fall injuries, lead exposure, and burns from spent casings. I understand these risks and voluntarily assume them in their entirety.
To the fullest extent permitted by law, I release, waive, discharge, and covenant not to sue [Range Name], its owners, employees, agents, contractors, and successors (the “Released Parties”) from any and all liability, claims, demands, actions, and causes of action arising out of or related to any loss, damage, or injury that may be sustained by me while on the property or while using its facilities.
I agree to indemnify, defend, and hold harmless the Released Parties from any loss, liability, damage, or cost they may incur arising out of my use of the range or my breach of this agreement.
8. Signature
Printed name
Signature
Date