MEMBERSHIP APPLICATION & HOLD HARMLESS WAIVEr SECTION 1: MEMBERSHIP INFORMATION Name * First Name Last Name Date of Birth * MM DD YYYY Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Emergency Contact * First Name Last Name Relationship * Emergency Contact Phone * (###) ### #### SECTION 2: MEMBERSHIP TYPE Annual Membership Monthly Membership Law Enforcement/ First Responder Discounted Rate Veteran / Active Military Rate Instructor Certification Enrollment SECTION 3: MEDICAL/PHYSICAL DISCLAIMER Do you have any medical conditions, disabilities, or physical limitations that may impact your participation in firearms or tactical training? No Yes SECTION 4: RULES AND CONDUCT ACKNOWLEDGEMENT I will follow all safety instructions provided by Tactical Solutions Academy instructors. * acknowledge by signing name below I will not handle any firearm unless authorized and under supervision. * acknowledge by signing name below I understand that use of Tactical Breathing – Controlling Chaos, Close Quarter Combat techniques, Laser Equipped Firearm training and Live-Fire exercises require mental and physical preparedness. * acknowledge by signing name below I will conduct myself in a respectful and responsible manner at all times. * acknowledge by signing name below SECTION 5: HOLD HARMLESS WAIVER & LIABILITY RELEASE READ CAREFULLY – THIS IS A LEGAL WAIVER In consideration of my participation in Laser Equipped Firearms training, Close Quarter Combat Tactical training, Tactical Breathing – Controlling Chaos and/or physical conditioning activities provided by Tactical Solutions Academy, I hereby acknowledge and agree to the following: 1. Assumption of Risk: I fully understand and acknowledge that Laser Equipped Firearms training/Live Firearms training and physical tactical instruction involve inherent risks, including but not limited to bodily injury, trauma, serious accidents, and death. 2. Release of Liability: I voluntarily release, waive, and discharge Tactical Solutions Academy, its Officers, Instructors, Agents, Employees, Affiliates, and Property Owners from any and all liability, claims, demands, actions, or causes of action whatsoever arising out of any loss, damage, or injury (including death) that may be sustained by me or to any property belonging to me while participating in activities or while on or near the premises. 3. Indemnification: I agree to indemnify and hold harmless Tactical Solutions Academy against any and all claims, suits, actions, liabilities, costs, and expenses (including legal fees) arising out of my actions or participation. 4. Medical Treatment Consent: In the event of an injury or medical emergency, I authorize Tactical Solutions Academy staff to seek appropriate medical treatment on my behalf and understand that I am solely responsible for any costs incurred. 5. Photo/Video Release: I grant permission for my image, voice, and likeness to be recorded and used for training or promotional purposes unless I provide written notice otherwise. 6. Binding Agreement: This waiver shall be binding upon me, my heirs, legal representatives, and assigns. Participant Name * First Name Last Name Digital signature * Date * MM DD YYYY If participant is under 18, Parent/Guardian must sign below: First Name Last Name Digital signature Date MM DD YYYY Thank you for your membership application submission. One of our team members will reach out to you as soon as we finish reviewing your application.
