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<br />SANTA ANA POLICE DEPARTMENT <br />INDIVIDUAL WAIVER OF LIABILITY <br /> <br />The City of Santa Ana and the Santa Ana Police Department assume no obligation in offering the <br />use of its Shooting Range Facility to the general public or other public agencies. There is a real <br />possibility of injury occurring when using the Shooting Range Facility, or while on the premises <br />while others are using the Shooting Facility. The undersigned acknowledges that the handling of <br />firearms, or being in the proximity of others using or handling firearms involves a significant risk <br />of serious physical injury including the possibility of death regardless of the skill of the user or <br />the adequacy of supervision or the instructions given. I understand that my signature constitutes <br />a request for permission to use the Shooting Range Facility with knowledge and understanding <br />that I assume the risk that I could be injured. I also understand that the City of Santa Ana would <br />not allow the use of the Shooting Range Facility unless I agree to waive any and all rights, <br />claims, demands, causes of actions including the right to sue the City of Santa Ana or its officers, <br />agents, employees, elected or appointed officials and the Santa Ana Police Department as set <br />forth below. <br />I understand that by signing this form: <br />A. I am agreeing to assume all risks of physical injury arising out of my use <br />of firearms and other related equipment or participation in the activities offered by the <br />City of Santa Ana; <br />B. I am waiving my rights with respect to any injury or damage I may sustain <br />as a result of or in any way related to my use of the Shooting Range Facility, or while on <br />premises when others are using the Shooting Range Facility. By way of illustration, I am <br />giving up my right to sue for inadequate instruction, inadequate supervision, faulty <br />equipment, or dangerous condition of the premises. My agreement to give up the right to <br />sue the City of Santa Ana does not extend to the willful acts or negligence of the City of <br />Santa Ana or their officers, agents, employees and representatives; <br />C. I agree to indemnify, defend and hold harmless the City of Santa Ana or <br />its officers, agents, employees, elected or appointed officials and the Santa Ana Police <br />Department from any and all damages, claims or losses caused by my use of any <br />equipment, my actions while participating or being on premises while others are <br />participating in the program, except to the extent arising from the willful acts or <br />negligence of Santa Ana, its officers, employees or agents. <br />D. I agree to comply with all posted rules and regulations and all orders of the <br />Santa Ana Rangemaster. <br /> <br />I have carefully read this form and fully understand its content. I am voluntarily signing this <br />waiver with knowledge of the rights I am giving up and the dangers involved in the activity. <br /> <br />Participant Signature <br /> <br />Printed Name <br /> <br />Badge No. <br /> <br />Witness: <br /> <br />Date: <br /> <br />Agency <br /> <br />12 <br />