Trainee's Name: (Please enter full name) I affirm that I am 18 years of age or older: (initials) Course Attending: Date(s) Attending: This ACKNOWLEDGEMENT, RELEASE AND WAIVER FOR FIREARMS TRAINING (Hereinafter refer to as "agreement") is for the express assumption of all risks, waivers and release from liability, including, without limitation, for any negligence, covenant not to sue and indemnification for all claims. This agreement also warns of the dangers of using this training outside the confines of this training course. I, , for valuable consideration and to induce permission to participate in fire arms training course conducted by PHOBOS SOLUTIONS LLC (hereinafter "company" and/or "PHOBOS SOLUTIONS") agrees to the following terms and conditions and makes the following warranties: I acknowledge that firearms/weapon training is a hazardous activity and is inherently dangerous. I am aware that this course is designed to instruct participants on the use of deadly weapons. I am aware that during this course I will be using live ammunition in a combat style firearm. I am aware that other participants in this course will be using combat style firearms and live ammunition in and around me to participate in training. I am aware that this activity involves dangers, risks and hazardous, including, but not limited to, DEATH, DISMEMBERMENT, DISFIGUREMENT, PARALYSIS, GUN SHOT WOUNDS, HEARING LOSS, PERSONAL INJURY, AND/OR DISABILITY. The risks associated with firearms training is increased when there are multiple individuals training with live firearms. * I HAVE READ, UNDERSTAND, AND AGREE TO THE TERMS OF THIS SECTION (initials) TRAINING SHOULD NOT BE MISUSED The firearms training offered by PHOBOS SOLUTIONS is designed, solely and completely for the purpose of self-defense, self-preservation, marksmanship, and/or other legal and permissible uses of a firearm. By attending this course and signing this document you are agreeing that you will not misuse this training. Any use of this training in a manner that is not consistent with the principles of self-defense and/or preservation is a misuse of this training. Any use of this training that is contrary to law is also a misuse of this training. PHOBOS SOLUTIONS specifically warns the possession, ownership, carrying, conceal carrying and/or discharge of a firearm are strictly regulated by federal, state, city and local laws, statutes, ordinances and/or other regulations. Accordingly, attendees should study and know the laws before using any firearm. PHOBOS SOLUTIONS does not offer teaching regarding federal, state, city and local laws, statutes, ordinance and/or other regulations about the ownership, carrying, conceal carrying and/or discharge of a firearm. Trainees should not presume that every exercise and/or technique taught in the firearms training class is a legal use of a firearm in any situation. It is the job of the participant to become familiar enough with federal, state, city and local laws, statutes, ordinances, and/or other regulations to ensure the proper, permissible and legal use of their firearm. * I HAVE READ, UNDERSTAND, AND AGREE TO THE TERMS OF THIS SECTION (initials) TRAINING DOES NOT GUARANTEE SUCCESS The training and techniques offered by PHOBOS SOLUTIONS and their self-defense oriented firearm training courses are designed to increase your chances of surviving a violent encounter, but does not guarantee your survival or the survival of your loved ones. Violent encounters are always unfortunate in the best way to survive one is to avoid it. In the event that you find yourself in a violent encounter or "life or death" scenario this training is merely designed to help your survival, but PHOBOS SOLUTIONS offers no guarantee that the participant WILL survive or emerge uninjured. Additionally, using the techniques taught PHOBOS SOLUTIONS can lead to the DEATH, DISMEMBERMENT, DISFIGUREMENT, PARALYSIS, GUNSHOT WOUNDS, HEARING LOSS, PERSONAL INJURY, AND/OR DISABILITY yourself, your loved ones, spouse, children, parents, family, friends, bystanders, innocent people, pets, or others. The training and techniques taught in this class are done in a supervised and controlled environment that is designed as a shooting range. However, in the unfortunate scenario that these tactics may be used outside of this setting there are significant dangers including, but not limited to, firearm malfunction, accidental discharge, engaging and appropriate target, bullets passing through walls, doors, or other objects and striking others, property damage, wounding bystanders, inappropriate use of deadly force and many other dangers which could lead to the DEATH, DISMEMBERMENT, DISFIGUREMENT, PARALYSIS, GUNSHOT WOUND, HEARING LOSS, PERSONAL INJURY, AND/OR DISABILITY of yourself and/or others. Use of the training and techniques taught by PHOBOS SOLUTIONS could also lead to your detainment, arrest, conviction and/or imprisonment. Federal, state and/or local authorities and/or Court systems are the ultimate decision makers on whether the use of a firearm will result in the levying of criminal charges, conviction of a crime and term(s) of imprisonment. PHOBOS SOLUTIONS does NOT offer training, advice, or counseling on the legal uses of a firearm, when to engage another human, what is a life threatening situation, the legal permissible scenarios for the use of deadly force, legal permissible use of deadly force for the protection of others. When using your firearm, you do so at your own risk. * I HAVE READ, UNDERSTAND, AND AGREE TO THE TERMS OF THIS SECTION (initials) I AGREE NOT TO SUE PHOBOS SOLUTIONS IF I AM INJURED - FOR ANY REASONS By this agreement, I accept full responsibility for, and fully release Company and its members, shareholders, officers, employees, contractors, agents, instructors, patrons, volunteers, property owner, range owner, insurers, underwriters, and any other related or subsidiary companies or affiliates (hereinafter "Released Parties") from, and do fully, completely and knowingly assume the entire risk of, any and all DEATH, DISMEMBERMENT, DISFIGUREMENT, PARALYSIS, GUNSHOT WOUNDS, HEARING LOSS, PERSONAL INJURY, AND/OR DISABILITY which may occur as a result the firearms training and/or hazardous activities in which I have chosen to participate, whether sponsored or permitted by the company or otherwise. By this agreement I understand and agree to release, discharge, hold harmless and absolve the Company and the Released Parties from any and all liabilities for any DEATH, DISMEMBERMENT, DISFIGUREMENT, PARALYSIS, GUNSHOT WOUNDS, HEARING LOSS, PERSONAL INJURY, DISABILITY OR ANY OTHER PHYSICAL OR MENTAL INJURY and/or any other losses, expenses, or measure of damages, including lost wages which should occur for any reasons, including those caused by the active or passive negligence of the Company and/or the Released Parties and waive and relinquish any and all claims, damages, and causes of action against Company and/or the Released Parties. I agree to not make any demands, file any claims or suits and/or seek any measure of damages, monetary or otherwise, against the Company or the Released Parties for any DEATH, DISMEMBERMENT, DISFIGUREMENT, PARALYSIS, GUNSHOT WOUNDS, HEARING LOSS, PERSONAL INJURY, AND/OR DISABILITY. I hereby expressly agree and affirm that I will bear the burden of any and all costs or damages incurred by reason of my DEATH, DISMEMBERMENT, DISFIGUREMENT, PARALYSIS, GUNSHOT WOUNDS, HEARING LOSS, PERSONAL INJURY, AND/OR DISABILITY directly or indirectly related to the firearms training course and the associated hazardous activities. Without limiting the foregoing, I further agree: 1. That neither I or any family member or next of kin shall have any right to make any claim against the Company and/or the Released Parties for injuries or damages sustained as a result of, or arising from, my participation in firearms training with the Company. 2. That I forever the Company and the Released Parties for any and all injuries, disfigurement, or physical harm, that I may sustain due to direct or indirect participation in the firearms training course and the associated hazardous activities. 3. That I will indemnify and hold harmless the Company and the Released Parties from and against any and all claims, damages, and/or liabilities that I might claim or that may be claimed by any third party or person arising out of the firearms training course and the associated hazardous activities, even if the Company or the Released Parties acted negligently. I UNDERSTAND THAT THIS SECTION OF ACKNOWLEDGEMENT, RELEASE AND WAIVER FOR FIREARMS TRAINING MEANS THAT I AGREE NOT TO SUE PHOBOS SOLUTIONS GROUP OR THE RELEASED PARTIES IF I AM INJURED OR KILLED DURING THIS COURSE AND/OR INSTRUCTION AND/OR IF I SUSTAIN DAMAGES OR INJURIES (MENTAL OR PHYSICAL) FOR ANY REASON. I UNDERSTAND THAT THIS ACTIVITY HAS THE RISK OF INJURY AND THAT BY PARTICIPATING IN THE COURSE I AGREE TO BEAR THE FULL RISK OF THE ACTIVITY. * I HAVE READ, UNDERSTAND, AND AGREE TO THE TERMS OF THIS SECTION (initials) OTHER TERMS AND AGREEMENT This agreement shall be binding upon heirs, next of kin, family, relatives, guardians, conservators, executors, administrators, trustees, and assigns. This agreement shall be governed by the laws of the State of Louisiana. If any section, paragraph, sentence, phrase, clause or word of this ACKNOWLEDGEMENT, RELEASE AND WAIVER FOR FIREARM TRAINING is for any reason held to be invalid or unenforceable by any court of competent jurisdiction, such decision shall affect the validity of the remaining provisions of this contract. Note: E-Signatgures, or electronic signatures, are legally binding for every business or personal transaction in the United States and complies with the definition of an electronic signature under the Electronic Signatures in Global and National Commerce (ESIGN) Act and the Uniform Electronic Transactions Act (UETA). * I HAVE READ, UNDERSTAND, AND AGREE TO THE TERMS OF THIS SECTION (initials) I HAVE READ AND UNDERSTAND THIS AGREEMENT AND HAVE BEEN GIVEN THE CHANCE TO ASK QUESTIONS I certify and acknowledge that I have completely read and UNDERSTAND this ACKNOWLEDGEMENT, RELEASE AND WAIVER FOR FIREARMS TRAINING and its terms. Prior to signing this ACKNOWLEDGEMENT, RELEASE AND WAIVER FOR FIREARMS TRAINING I have had the opportunity to ask any questions I desired about the firearms training course, the hazardous activities associated there with and the terms of this ACKNOWLEDGEMENT, RELEASE AND WAIVER FOR FIREARMS TRAINING. * I HAVE READ, UNDERSTAND, AND AGREE TO THE TERMS OF THIS SECTION (initials) I am fully and completely aware of the meaning, intent and consequences of signing this ACKNOWLEDGEMENT, RELEASE AND WAIVER FOR FIREARMS TRAINING and I hereby knowingly do so willingly, voluntarily and of my own free will Trainee's e-signature: (full name) Date Signed: (month, day, year) PHOTO AND VIDEO RELEASE I agree that my image, whether photographed or videoed during any PHOBOS SOLUTIONS courses I am participation in, can be used by PHOBOS SOLUTIONS as PHOBOS SOLUTIONS deems appropriate, including use in promotional materials, websites and social networking sites. Trainee's e-signature: (full name) Date Signed: (month, day, year) TRAINEE'S PERSONAL INFORMATION: (fill out in full) Trainee's Name: (full name) Address: (City) (State) (Zip Code) Date of birth: (month, day, year) Email address: Please review all information above. Be sure you have filled out the form in its entirety. Once you are done, please press "SUBMIT FORM" - If you need to make changes, use the "RESET FORM" button before sending.