Personal Information

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

I understand the nature and risks of this activity and that I am qualified, am in good health, both mentally and physically, as well as possess the physical fitness standards displaying proper health, maturity and mental health condition to participate in such activities.

I fully understand that these activities involve risks of serious bodily injury, including permanent paralysis, disability and/or death, which may be caused by my own actions, or inactions, those of others participating in the training, the conditions in which training takes place, or the negligence of the releasees named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, costs and damages I incur as a result of my participation in the training.

I hereby release, discharge and covenant not to sue Instructor Arnaldo Adasz and his respective agents, officers, partners, volunteers, employees, instructors, consultants and trainers. This is to include other participants, sponsors, advertisers, and if applicable, owners and lessors of premises on which this training takes place from all liability, claims, losses or damages on my account caused or alleged to be caused in whole or in part by the negligence of the releasees or otherwise, including negligent rescue/aid operations; and I further agree that if, despite this release, waiver of liability, and assumption of risk, I or anyone on my behalf makes a claim against any of these releasees, I will indemnify, save, and hold harmless each of the releasees from any loss, liability, damages, or cost which they may incur as the result of such claim.

I have read this agreement, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement of any nature, and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law.

The undersigned, in consideration of the receipt of any training, advice, or instruction, use of facilities, equipment, ammunition, loan of any firearm, does hereby relinquish and waive any claims or causes of action for damages or any other kind of liability whatsoever, including gross as well as simple negligence. Any loss, damage or injury including death, that may be sustained by me against Instructor Arnaldo Adasz.

I understand that:

1. Live ammunition is not permitted in the classroom.
2. Reloaded ammunition is not permitted due to major safety risks.

I agree and acknowledge that it is my sole responsibility to obtain necessary training and documentation required to establish competency in the safe handling and discharge of firearms, as required by Florida State Statute 790.06. The Instructor provides no guarantee that completion of the course will result in the issuance of a Florida Concealed Weapons License.

I also agree that if I am either pregnant or believe that I may be pregnant, or have any medical or health condition that might affect my ability to safely participate, I shall advise the instructor prior to the firing portion of the class.

ASSURANCE OF NON-PROHIBITION — I certify that:

1. No oral representations, apart from the foregoing written agreement, have been made.
2. I am at least eighteen (18) years of age and fully competent, or am under the supervision of a fully competent adult.
3. I am not under the influence of alcohol, illegal drugs, or prescription medications that impair my judgment.
4. I am not prohibited from the use, purchase, ownership, or possession of a firearm in Florida and the United States in accordance with Florida State Statute Title XLVI Chapter 790 Section 23 and/or The 1968 Gun Control Act (18 U.S.C. § 921 et seq.).
5. I authorize Instructor Arnaldo Adasz to use photographs and/or videos of me for lawful purposes including publicity, advertising, and web content.
6. I execute this Release for full consideration, fully intending to be bound by same.
7. This Waiver shall remain in full force unless revoked in writing and delivered to Instructor Arnaldo Adasz.