Entered:____

PRINT NAME: _________________________________FOID #: ________________Exp. Date_______

Address: _________________________City: ______________State: ______ Zip: ______County: ______

Phone Number: ___________________________ Email: _________________________________

Disclaimer and Waiver

The Undersigned acknowledges that FIREARMS POSSESS AN INHERENT DANGER IF MISHANDLED. Therefore, common sense is
required at all times. The following is a list of rules that are imperative to the safety of the shooter and all surrounding parties.

All firearms must be unloaded and encased when entering or exiting the premises. _______
1. No person under the influence of alcohol and/or drugs is allowed on the premises. ________
2. No rapid fire, cross fire or holster drawing is permitted. (2) second delay between shots. ________
3. Hearing and eye protection must be worn at all times while in the shooting range. ________
4. All loading of magazines must be done inside your lane. ________
5. All brass on the floor is now the property of RKA Gun Gallery. ________
6. Never move forward of the firing line. ________
7. RKA can ask anyone not abiding by RKA rules to leave the premises without refund. ________
8. You must be 21 years old and have a valid FOID (Firearm Owner Identification) card to shoot handguns. At least 18 years of age to
shoot rifles. Anyone under the age of 18 must be accompanied by a parent or legal guardian with a valid FOID.
9. Two (2) people are required to rent a firearm. The shooter must have a valid FOID card and 21 years of age. All ammunition for range
firearms must be purchased through RKA Gun Gallery.
10. No steel core, armor piercing, buck shot or bird shot, tracer ammunition allowed in range. NO OUTSIDE RELOADS!!!
11. No exploding or human faced targets are permitted. All outside targets must be approved by RKA Gun Gallery.
12. Black powder firearms are PROHIBITED!
13. ALWAYS ASSUME YOUR FIREARM IS LOADED AND TREAT IT ACCORDINGLY!!
14. Always keep the firearm pointed in a safe direction; down range.
15. Always keep your finger off of the trigger until you are ready to shoot.
16. Know how your firearm operates; understand the operating mechanisms and safety procedures.
17. If your firearm malfunctions, lay it on the shooting bench with the muzzle pointed down range and notify the Range Safety Officer.
18. Concealed Carry firearms must remain concealed when not being shot.
19. You are responsible for cleaning up after yourself. Please recycle your targets and ammo boxes in the container provided. Your bench
should be clear before you leave and your target carrier should be retracted and clear.
20. NO FOOD, BEVERAGES, GUM OR TOBACCO IN THE RANGE.
21. It is unlawful to use this facility with any malicious intent. Everyone must abide by all federal, state and local firearm laws
22. Commands issued by the Range Safety Officer (RSO) must be obeyed immediately and without question.
23. Range Officers have the right to inspect any firearm or ammunition for safety consideration.
24. Always wash your hands and face immediately after shooting or cleaning your firearm. Sinks are located in the washrooms.
25. All guns MUST BE CASED AND UNCASED ON THE BENCH IN THE RANGE. No moving of uncased firearms to different lanes.

It is incumbent upon all shooters to act responsible. If you observe an unsafe condition or action, report to a Range Safety Officer or
RKA Gun Gallery employee immediately. RKA Gun Gallery reserves the right to deny access to or remove any individual deemed
unsafe or a threat to themselves, other individuals, the facility and/or violation of the establishment rules.By signing this disclaimer
and waiver, the undersigned is certifying in writing that he/she has read and understands the range safety rules prior to entering and
using the range and all other areas of RKA Gun Gallery. Failure to abide by these rules may result in a reprimand and/or removal
from the range.

I, the undersigned, my agents, executors or administrators, for the consideration of being allowed to enter, rent, and use the
facilities, firearms and services of RKA Gun Gallery and for all the other goods and valuable considerations, do hereby absolutely
and unequivocally agree to release and save harmless, RKA Gun Gallery, it’s agents, employees, instructors, Assigns and
Successors from any claim, demand or liability whether claimed by myself or another arising out of any injury, loss or disability
connected with the above use of the facilities or services.

Signature confirms applicant voluntarily accepts this waiver and understands and agrees to abide by the range rules stated above.

Signature: ______________________________________________Date:_____________________