Wayside Skeet Club

ASSUMPTION OF RISK:
WAIVER & RELEASE OF LIABILITY:
INDEMNIFICATION AND HOLD HARMLESS AGREEMENT:

In consideration for the WAYSIDE SKEET CLUB granting membership to me or allowing me to be present and/or shoot skeet, and recognizing that the sport of skeet shooting potentially involves substantial risks and hazards to persons and property, both known and unknown, including inexperienced or careless shooters, equipment failures, and other potentially dangerous factors capable of causing serious bodily injury and including negligent acts or omissions by other shooters, I hereby waive any claim or cause of action to which I may be entitled as a result of my membership and/or presence at the Wayside Skeet Club against the Wayside Skeet Club, Inc. and/or its officers, directors, members, agents, employees and volunteers and the Wayside Land Company, Inc. and/or its officers, directors, members, shareholders, agents, employees and volunteers. Additionally, I assume the risk of all such potential injuries and damages, whether foreseeable or not and I agree to indemnify and hold them harmless from any claims, harm, damages or injuries which I now or hereafter may suffer resulting from my presence at this facility, whether instituted by me or any other person. I do not waive any claim or cause of action against any individual who negligently or intentionally causes bodily injury or property damage to me.

I agree to abide by the instructions of the Range Officer-of-the-Day, to follow the general rules of safe gun handling and the House Rules of the Wayside Skeet Club, Inc., and to exercise good judgment and safe gun handling at all times, and I hereby certify to the Wayside Land Company, Inc. and the Wayside Skeet Club, Inc. that I am familiar with the rules of safe gun handling and I have read the House Rules of the Wayside Skeet Club.

I will not use ammunition that contains shot larger than size #8,
I will not use ammunition that is loaded to exceed a muzzle velocity of 1200 fps.
I will not use any firearm other than a shotgun of 12 gauge or smaller bore.

In the event that any portion of this document shall be held invalid, it shall not affect the remainder thereof, which shall continue in full force and effect.

I certify that I have carefully read and understand the contents of this document, that it is a release of liability, an assumption of risk, a waiver of claim, and an indemnity and hold harmless agreement, that I am of lawful age, of sound mind and I execute it of my own free will and state that this release, assumption, waiver and promise shall remain in effect so long as I am a member of the Wayside Skeet Club or a guest shooter thereof.

CIRCLE - Member, Guest of a Member, Registered Shooter at an NSSA Sanctioned Shoot or a Non-Shooting Visitor/Spectator:

Signature: ______________________________________________________ Date: ____________20___

My Name - Printed: _________________________________________________________________

This form is for my under-age child: Name______________________________________________________

I am the guest of (Host Member's Name) - Printed:__________________________________________

Revised Nov. 4, 2009

Each adult member, family of a member, guest shooter, visitor and Registered Shooter must sign a form and a parent must sign a form for each of his children under age 21 who uses WSC facilities.  Member's Forms and forms for Member's Family are kept on file.  Others must sign a separate form annually.


Print this form, sign, date and deliver or snail-mail it to:

Wayside Skeet Club
Attn: Range Officer
621 Green Grove Road
Tinton Falls, N. J. 07712-3112


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