Firearm Experience & Safety Questionare

Everyone who wishes to shoot in this facility, whether using their own or a rental firearm, must completely fill out this form. All information supplied will be kept secret confidential, not distributed or made available to others for any purpose, and is for the sole use of The Gun Range indoor shooting facility, to properly identify the user and to document their previous firearm experience. This is being done to best ensure the safety of all range users.

User Identification

First Name

Last Name









Work Phone

Shooting Experience

1st Time





Hand Gun



Safety Questionare

Yes No

Have you ever had any history of mental illness?

Have you ever been convicted of a felony?

Have you ever been convicted of a misdemeanor?

Are you an unlawful user, or are you addicted to any narcotics or controlled substance, legal or not?

Do you have a problem with alcohol abuse?

Applicant, for itself and its executor, and assigns, releases The Gun Range from any and all liability for personal injury or property damage arising out of the use of the equipment and/or facilities of The Gun Range, and agree to hold The Gun Range, free, clear and harmless for and indemnify The Gun Range from any responsability for any and all claims and demands for personal injury or property damage arising out of such use.

By signing below, I certify that there is no legal reason to prevent me from visiting, using, renting and/or shooting at this range facility.

I have read and fully understand the range safety rules as set forth by The Gun Range
I further declare that the above information is true, complete and accurate.
I would like to receive special offers and event notices from The Gun Range via e-mail.