School Extracurricular Application

Child/Participant's Name*
First Last
Date of Birth*
DD slash MM slash YYYY
Age*
Parent/Guardian Name*
First Last
Tel No.
Cell No.*
Email*
Does the child have any experience with airguns/guns?*
- Yes
- No
Please note that your child does not require any experience, it is just advantageous for our instructors to have background on each student.
Please give background if answer is yes.*

INDEMNITY AND WAIVER
This is an indemnity and waiver of liability in respect of the use by the Customer of the company’s airgun shooting range. By signing this indemnity and waiver, the signatory warrants that he/she has read understood, and accepts its terms.
A. DETAILS OF THE COMPANY
Name: PATRIOT OUTDOORS (PTY) LTD
Registration number: 2019/448114/07
Address: Baruch Park Unit 6,7,14
South Corner of Viro Crescent and Buchan Street
Stikland
Cape Town
7530
Postal Address: PO Box 1110
Malmesbury
Western Cape
7299
Representative: Johan Kemp
Services: The Company’s services include the provision of an outdoor experience in an indoor air gun shooting range, and sells a range of airguns, optics, slugs, and airgun-related products.
B. PERSONAL DETAILS OF PARENT/ GUARDIAN
Title*
Initials*
Name*
First Last
ID / Passport No.
Date of Birth*
DD slash MM slash YYYY
Tel No.
Cell No.*
Email Address*
Residential Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Postal address the same as residential address
- Yes
- No
Postal Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

C. INDEMNITY AND WAIVER OF PATRIOT OUTDOORS*
I agree to the following:
My child voluntarily enters the Company’s premises, on which the shooting range is situated, (“the Premises”), to engage the air gun shooting range services and use the Company’s facilities on the Premises. The services provided by the Company include the (i) rental and/or use of air guns, (ii) the supervised and/or unsupervised discharging of air guns provided by the Company or otherwise, as well as (iii) training provided by the Company’s employees or agents.

I understand and acknowledge that if my child fails to obey an agent or employee of the Company’s instructions, range rules, the airgun safety rules, or any other term of this Waiver and Indemnity, I and my child will be subject to expulsion from the range and our usage rights. There will be no refund of any monies, membership dues, or administration fees paid if any person is required to leave the property, or any membership is suspended or revoked as noted herein.

I understand and acknowledge that the shooting of airguns is inherently risky and may result in the damage or destruction of property, physical or emotional harm, injury or death to a person, including being shot or shooting others resulting in loss of eyesight, hearing and other injuries caused by flying objects, including ricochets. I understand that these risks can be mitigated but not eliminated.

The Company makes no warranties, guarantees, or other representations about the design, manufacture, fitness for purpose, or condition of the shooting range, the air guns, first aid supplies, and other related equipment or facilities or the skill or experience of any of the staff or Company agents on the Premises.

I assume full responsibility for all risks, injury to person or property, damages (quantified or unquantified), of all kinds and whatever nature, including theft, which might result from entering the Premises, using the shooting range, and
using any other facilities on the Premises regardless of whether the harm was caused by intentional or negligent acts or omissions by the Company, its agents or any of its guests at the Premises.

I hereby hold the Company, its agents, members, and officers harmless for all harm, contemplated in clause 6, suffered by me or any guests on the Premises, however, caused, and waive any claims against the Company in that regard. Notwithstanding the terms in this indemnity and waiver, the total liability of the Company to the Customer shall be limited to the fees paid by the Customer to use the shooting range.

I hereby indemnify the Company against any harm, damage, or liability incurred or arising because of my child’s acts or omissions while on the Premises.

I agree to have my child act in accordance with the Company’s code of conduct, operating and safety procedures, and the instructions of any of the Company’s agents on the Premises.

I agree that this indemnity and waiver shall be binding in respect of every time that I or my child use the shooting range or enter the Premises.

I hereby accept financial responsibility for the replacement or repair of any Company property that I may damage while on the Premises.

E. PHOTO RELEASE CONSENT (MINORS)*
I confirm that I am legally competent to consent to any action or decision being taken in respect of a matter concerning the minor/s listed at E in this document, as contemplated in POPIA.

I hereby give voluntarily consent to the Company taking photographs of the image and likelness of the minors listed in E in this document, on their behalf, and grant permission to the Company to sue the resulting photographs, both edited and unedited, on the basis set out below. By ticking “YES” I confirm that I have read and understand the terms of the release and agree to be bound thereby, on behalf of the minor/s.
- Yes
- No
Consent
I hereby acknowledge that I have read and understood this Waiver and Indemnity and accept the terms and conditions contained herein.
My consent is subject to the following terms and conditions:

the Company may use any of the photographs of my child for marketing and promotional purposes as well as news releases, which shall include hardcopy and online publications as well as publication on social media platforms, on a worldwide basis.

I understand that I will not be entitled to any form of royalties or other compensation relating to the use by the Company of any photographs of my child.

I waive the right to inspect the photographs before they are published.

I hereby hold the Company harmless and waive any claims, demands, and causes of action which I may have against the Company in respect of this photo release consent.

Photographs of my child constitute personal information for the purpose of the Protection of Personal Information Act, 2013, (“POPIA”) and I confirm that the Company has disclosed the purpose of processing my personal information and further that I have been directed to the Company’s Information Manual containing further information about its privacy policy and other data provisions at http:/patriot-outdoors.com.

Customer consent*
I agree to the waiver details
1. Only airguns allowed.
2. No airguns allowed larger than .22 calibre without a license or permit.
3. The use of steel ammo is not allowed
4. Always keep your airgun in a rifle bag or rifle case until you are at your shooting point.
5. Always keep airguns pointed in a safe direction.
6. Always keep your finger off the trigger until ready to shoot.
7. Always keep your gun unloaded until you are at the firing line, and the range is declared "HOT."
8. Always keep your airguns safe (unloaded - magazines removed and actions opened) when entering or exiting the range.
9. Always respect and obey the instructions and commands of the Range Officer.
10. Cease Firing: Immediately stop shooting when anyone calls "Cease firing."
11. COLD Range: Shooters must check with others to ensure airguns are unloaded, actions open, and airguns laid down on the shooting bench before going downrange. No one is permitted to handle airguns or stand at the
firing line while there is a cold range.
12. HOT Range: Shooters must check with others to ensure there is no one down range when the range is declared "HOT." Shooters are permitted to commence firing.
13. Only shooters are permitted on the firing line. An adult must always accompany children under 16 years of age.
14. Shooters may move safe guns to and from the firing line only when the range officer permits them to do so.
15. The Range Officer may only handle all gates and access points.
16. All shooters are responsible for their rounds, staying within the confines of this range. Shooters may shoot only from the firing line at the target in line with their position. Shooting at items placed on the ground or at targets not posted at the appropriate height on the target frame enables projectiles to escape the range.
17. Respect the Range:
17.1. Place your trash into the trash bins.
17.2. DO NOT shoot at the taxidermy mounts.
17.3. When going downrange, stay on the walkway to and from the targets-access to the backstop, and all areas outside of the target lines and walkways are prohibited.
18. Respect Yourself:
18.1. Wear eye protection always.
18.2. Wear ear protection when needed.
19. NO Food, beverages, or smoking are allowed on the firing line.
20. Respect Others: There is a one-hour time limit for the use of the range if patrons are waiting.
21. No persons are allowed through the range entrance gate without permission from the range officer.
22. Only members and paid visitors are allowed past the range entrance gate.
23. Spectators are not allowed behind shooting benches unless you are an adult supervising your child. Please use the upstairs lounge for spectating.
24. Tethering from air tanks is not allowed without permission from the range officer.
25. The usage of the Patriot air-filling station will be done under the range officer's supervision only. The usage of handpumps and compressors is not allowed on the range.
Shooting at any printed decal or printed animal on the range, other than the paper targets on the backstop, is forbidden. If caught doing so, you will be held responsible for damages.

I hereby acknowledge that I have read and understood this Waiver and Indemnity and accept the terms and conditions contained herein.
Confirmation*
I agree to share the above rules and regulation with my child and have them adhere to them.
This is an indemnity and waiver of liability in respect of the use by the Customer of the Company’s airgun shooting range. By signing this indemnity and waiver, the signatory warrants that he/she has read, understood and accepts its terms.
Confirmation*
I hereby acknowledge that I have read and understand the content of this form and accept the terms and conditions as contained herein.
Signature*
Place*
Date*
DD slash MM slash YYYY
Email
This field is for validation purposes and should be left unchanged.

Patriot Indoor School extracurricular application

Step 1 of 7

INDEMNITY AND WAIVER

A. DETAILS OF THE COMPANY

B. PERSONAL DETAILS OF PARENT/ GUARDIAN

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Name of Participating Child	Date of birth	Relationship