Minor Application

If the undersigned brings a guest who is UNDER the age of 18, please complete the following authorization for each minor to use the facility with Adult/Guardian present.

I, (Adult/Guardian) First Name*

Last Name*

of (Minor)*

and (Additional Minor, if needed)

I have read, understood and will comply with the rules and safety procedures*

I give my written consent of the above minor to participate in the shooting of firearms and bows at the Stephenson Mid-County Sportsmen’s Club. I agree to enforce all shooting range rules, policies, and directives with the minor and to supervise and monitor any and all activities of the minor while on the shooting range and while on range grounds. I agree to release, acquit, indemnify the Stephenson Mid County Sportsmen’s club, it’s officers, volunteers, managers, assigns, employees from any and all liability for any harm, injury, or death resulting from activities of the minor while on the Mid-Country Sportsman’s shooting range or property.*

Electronic Signature*

Date*

Email*

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