Release Of Liability And Assumption Of The Risk

Name *

First

Last

Date of Birth

Email *

Name of Course / Event you will be attending *

Date of Course *

I understand that I am participating in an organized small arms, concealed carry, close-quarter combat/physical defense, specialized training and/or tactical training event or course of instruction (Course), using the training facilities, and/or participating as a spectator. Participation and/or observation of such a Course exposes me to potential major and minor injuries including, but not limited to gunshot wounds, blunt force trauma, lacerations, soft tissue injuries, injuries caused by back-splatter from steel targets, broken bones, concussions, etc. *

Initials

I am participating in this Course on my own free will and FULLY UNDERSTAND AND ACCEPT the inherent risks associated with this training I choose to be involved in; and as a result, I, my family and heirs WILL HOLD HARMLESS AND FOREVER RELEASE the training facility, training facility owner, Progressive F.O.R.C.E. Concepts, LLC training organization (the Training Organization), and Training Organization Instructor(s), including but not limited to Stephen J. Krystek, owners, associates, affiliates, immediate family, extended family and heirs from any liability whether intentional or unintentional acts or actions, injuries or death to my person, injuries or death to another person, or damage to property resulting from my participation in training and firing range use. *

Initials

If I must use a Blackhawk Serpa holster or any holster that utilizes a trigger finger actuated retention mechanism, I do so of my own free will, fully recognizing and accepting the risks and hazards associated with this equipment. Furthermore, I WILL NOT make any legal claims of damage or losses resulting from injuries sustained during this or any other training or special event conducted by Progressive F.O.R.C.E. Concepts, LLC, or initiate any legal action of any kind against Progressive F.O.R.C.E. Concepts, LLC now or in the future. *

Initials

I understand the local environmental conditions are unforgiving and further, hydration is my responsibility. Breaks to consume water have been provided by the Facility, Training Organization, and/or Instructors. Furthermore, I, my family and heirs WILL HOLD HARMLESS AND FOREVER RELEASE the training facility, training facility owner, the Training Organization (Progressive F.O.R.C.E. Concepts, LLC), and Training Organization Instructor(s), including but not limited to Stephen J. Krystek, owners, associates, affiliates, immediate family, extended family and heirs from any liability resulting from my future actions as a result of the training obtained during this Course. *

Initials

By my signature on this document, I state that I have no criminal history preventing me from possessing a firearm and am not wanted for questioning or arrest by any law enforcement or government agency. I further state that I have no history of mental illness or substance abuse, and that I am not currently under, nor will I be under, the influence of alcohol or other controlled substance while participating in this training or special event. I understand that my training or participation may be terminated at any time during the Course if my actions are not deemed safe or appropriate by the training staff. I agree to follow and abide by ALL safety rules and procedures outlined by the training staff and will immediately report any sustained injuries. *

Initials

I have no preexisting medical conditions that prevent me from attending and participating in this training. *

Initials

I fully understand this document I have read, agree to abide by all of the above conditions, and understand this document is valid for and applies to the duration of the above entitled training course of instruction or special event from the beginning date to the end date: *

Clear Signature

Signature - On PC/Mac hold mouse over box until crosshair appears, click-hold down, write name. On mobile device use finger to write name.

Date

39875