Loaner Gun

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LOANER GUN SAFETY BRIEFING

IF YOU ENCOUNTER ANY PROBLEMS WHATSOEVER OR HAVE ANY QUESTIONS ABOUT THE GUN, CEASE USE IMMEDIATELY AND CONTACT THE CLUBHOUSE. The phone number is posted at each station.

• If squad is using a 12ga. and a 20ga. shotgun, the 20ga. shells need to be kept separate from the 12ga. shells because a 20ga. shell will slide partially down the barrel of a 12gs. shotgun and then a 12ga. shell can be inserted. If fired in this condition, the gun barrel will blow up resulting in a catastrophic failure of the firearm which will cause serious bodily harm or death.

• The barrel of the shotgun must be over the station’s front rail and pointed down range before inserting any shells into the gun and closing the gun.

• Trigger Safety – The trigger safety is on when engraved “S” is visible. Push it forward to turn safety off. No guns, 12 or 20 gauge, return to the safe position after the action is opened and closed. Never assume the safety will protect against a discharge.

• Keep the action open at all times. For break action, the gun is to be broken open. The action is only to be closed when: (A) you are in the station with the barrel over the front rail pointing down range (B) empty with the muzzle positioned up in a gun rack (C) empty with the muzzle in an upright position while transporting in a golf cart. If you are walking the action must be kept open. For semi-autos, pump actions or bolt actions, the ONLY time the action can be closed is when you are in the station with the barrel over the front rail pointing down range and ready to fire. Always treat a gun as if it is loaded. Never pass the gun barrel past a person even when the gun is open.

• Do not put your finger on the trigger until you are ready to shoot.

• Never slam the action closed, it could cause the gun to discharge or damage the action/trigger.

• No practice mounts or swings outside of the shooting station.

• Catch empty shells or pick up at the end of shooting station.
- For break action guns, after you take your two shots; catch the empty shells when opening the gun and throw them away, if they fall to ground, pick them up after your squad is done shooting.
- Semi-automatic/pump action – wait until your squad is finished shooting and then pick up the empty shells.

• Misfire – KEEP THE GUN POINTED DOWN RANGE, wait 15-30 seconds, then open the gun facing down range. DO NOT throw the live round into the garbage can. Keep the shell separate and bring it to the Clubhouse for proper disposal when you are done shooting.

• Be aware of a “Squib” load which occurs when a fired shotgun shell does not have enough force behind it to push the shot and wad to exit the barrel, thus becoming stuck in the barrel. It can be identified by a muffled sound and/or light recoil. This type of malfunction can be extremely dangerous, as failing to notice the wad has become stuck in the barrel may result in another round being fired into the obstructed barrel. [The Code Word for Question 12 on Page 1 is AXXB] If fired in this condition, the gun barrel may blow up resulting in a catastrophic failure of the firearm’s structural integrity which will cause serious bodily harm or death.

LOANER GUN WAIVER AND RELEASE OF LIABILITY

In consideration of Coal Ridge Sporting Clays (“CRSC”) furnishing services, equipment, and/or the facilities and in connection of my participation in clay shooting and other related activities (the “Sport”).

I agree as follows: I fully understand and acknowledge that:
(a) There are risks and dangers in my use of Sport equipment and my participation in the Sport;
(b) My participation in the Sport, use of Sport equipment, and/or presence at CRSC’s facilities may result in damage to or loss of personal property, personal injury, death, or other ailments that could cause serious disability;
(c) These risks and dangers may be caused by the negligence of the shareholders, officers, directors, employees or agents of CRSC, the negligence of others, accidents, breaches of contract, forces of nature or other causes, and that risks and dangers may arise from foreseeable or unforeseeable causes, and;
(d) I, on behalf of myself, my family, heirs, executors, administrators, representatives and assigns, assume all risks and dangers and all responsibility for any losses and/or damages which result from my participation in the Sport or presence in or on CRSC’s facilities;
(e) I have read and understand the Course Rules and have previously signed a Waiver and Release of Liability and will be responsible for any damage or abuse to the gun;
(f) I have read and understand the Loaner Gun Safety Briefing on the back of this form.

Please answer the questions below:

Questions to Answer

1.) Are you prohibited from owning or using a gun in any state?(Required)

Yes

2.) Are you under indictment or information in any court for a felony, or any other crime, for which the judge could imprison you for more than one year?(Required)

Yes

3.) Have you been convicted in any court of a felony, or any other crime, for which the judge could imprison you for more than one year, even if you received a shorter sentence including probation?(Required)

Yes

4.) Are you a fugitive from justice?(Required)

Yes

5.) Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, or narcotic drug, or any other controlled substance? The use of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreation purposes in the state where you reside.(Required)

Yes

6.) Have you ever been adjudicated mentally defective or have you ever been committed to a mental institution?(Required)

Yes

7.) Have you been discharged from the Armed Forces under dishonorable conditions?(Required)

Yes

8.) Are you subject to a court order restraining you from harassing, stalking, or threatening your child or an intimate partner or child of such partner?(Required)

Yes

9.) Have you been convicted in any court of a misdemeanor crime of domestic violence?(Required)

Yes

10.) Have you used a shotgun before?(Required)

Yes

11.) Please indicate your proficiency with a shotgun:(Required)

First Time

Knowledgeable

Experienced

12.) You must read the safety notice on the first part of this application. What is the code word?(Required)

13.) Are you the actual user of the gun?(Required)

Yes

Who is the actual user of the gun?

14.) Will anyone else be using the gun?(Required)

Yes

Who else may be using the gun?

15.) Have you consumed any alcoholic beverages or illegal drugs in the last 12 hours?(Required)

Yes

16.) Do you have suicidal tendencies?(Required)

Yes

Consent

I certify that the above answers are true and correct.

Contact Information

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Loaner Gun

LOANER GUN SAFETY BRIEFING

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