All Shooters, members and guest, at palmetto gun club are required to have this form on file. if you have not filled this out, you can not shoot in a long range match( or other match held at PGC). print and sign from the link below:
Palmetto Gun Club, LLC
P.O. BOX 2822
Summerville, South Carolina 29484-2822
Release, Hold Harmless and Waiver of Liability Agreement
(Original of 6/20/2020)
I (print your name) _____________________________________________ presently residing at
(Street Address) ________________________________________________________________
(City) _________________________________________________ (zip code) ______________,
Being above the age of 18 years and in consideration of the right to enter and use the facilities and services of the Pal-
metto Gun Club, LLC (hereinafter PGC), do hereby enter into this Release, Hold Harmless and Waiver of Liability
Agreement (this “Agreement”) on this _________ day of _____________, 20___, and consent and agree that:
1.Acknowledgement of Danger. I acknowledge that engaging in sport shooting is dangerous. I further
acknowledge that no matter what precautions I may take, including but not limited to the wearing of various
types of protective gear (including hearing and eye protection), that I could experience injury of serious na-
ture and/or die as a result of an accident or incident. I am also aware of the risks imposed by exposure to COVID-19. I
therefore engage in such activities voluntarily and at my own risk.
2.Assumption of Risks. I acknowledge and represent that I am familiar with the significant risk and danger-
ous nature, including but not limited to causing death or serious bodily injury to myself or others, and causing
death or serious bodily injury to myself and others, and causing damage(s) to property, which originate from
participating and otherwise engaging in sport shooting. I hereby assume any and all responsibilities and liabilities per-
taining to such risks, including the risk of exposure to COVID-19, whether to myself or to others and without limitation
or qualification. There have not been any express or implied representations to you on behalf of the Club except as set
forth in this Agreement.
3.Physical and Mental Condition. I acknowledge that at the time of signing this Agreement I am in sufficient physical
and mental condition to engage in sport shooting on this range.
4.Condition of Equipment. I have, prior to engaging in any sport shooting at the Club, determined that, by profession-
al standards, my shooting equipment, ammunition and all corresponding items are in good condition and suitable for the
shooting contemplated by this Agreement.
5. Comprehensive Release. I agree that I am personally responsible for my safety and actions while using
the facilities at PGC, I agree to comply with all PGC policies and rules, including but not limited to all PGC
policies, guidelines, signage and instructions. Because the PGC is open for use by other individuals, I recog-
nized that I am at higher risk of contracting COVID-19.
With full awareness and appreciation of the risks involved, I, for myself and on behalf of my family, spouse, estate,
heirs, executors, administrators, assigns (collectively the “Released Parties”) from any and all liability, claims, demands,
actions and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage or injury, in-
cluding death, that may be sustained by me related to activities conducted at the PGC or to negligence of the Released
Parties, any third-party using the PGC or otherwise, wile participation in any activity while in, on, or around the PGC
and/or while using any PGC facilities, tools, equipment or materials.
6. Indemnity. I hereby indemnify, without qualification or limitation, the Release Parties and defend and hold the
Released Parties harmless from and against any and all claims, causes of action, demands or charges of every kind and
nature, which any third party or person may claim to have or to hold for property damage or personal injuries or any
other damages including death, arising from cause or reason, of every kind and nature pertaining to this Agreement originating from
my relationship with any of the Released Parties and any activity directly or indirectly arising from or contemplated by this
Agreement or specifically related to COVID-19.
7. Governing Law; Attorney’s Fees. This Agreement shall be governed by, and construed in accordance with the
laws of the State of South Carolina. Should any party hereto institute any action or proceeding against the other party at
law or in equity, or in connection with an arbitration, in connection with this Agreement, the prevailing party from such
action shall be entitled to recover from the losing party or parties all attorney’s fees and costs for service rendered to the prevailing
party in such action or proceeding.
8.Additional Regulations. I have read and understand, and I agree to follow the requirements as set forth in the Club’s
Shooting Range Shooting Regulations, “a copy of which has been provided to me by the Club. I also understand that
hearing and eye protection (even while using a scope) are mandatory at all areas so designated by the Club. Any
ammunition purchased or obtained from the Club will only be used at the Club’s range.
By signing below I acknowledge and represent that I have read the foregoing Waiver of Liability,
understand it and sign it voluntarily as my own free act and deed, including without limitation the
Release of Liability and Indemnification requirements contained in this document; I am sufficiently
informed about the risks involved in using the PGC to decide whether to sign this document; no oral
representations, statements, or inducements, apart from the foregoing written agreement, have been
made; I am eighteen (18) years of age and fully competent; and I execute this document for full,
adequate, and complete consideration fully intending to be bound by the same. I agree that this Waiver
of Liability shall be governed by and construed in accordance with the laws of South Carolina, and that
if any of the provisions hereto are found to be unenforceable, the remainder shall be enforced as fully as
possible and the unenforceable provision(s) shall be deemed modified to the limited extend required to
permit enforcement of the Waiver of Liability as a whole.
PHONE # ___________________________________________________________________________
DRIVER’S LICENSE # ________________________________________________________________