Reserved Range Shooter Application

	APPLICATION FOR RESERVED RANGE USE CARD VALID FOR USE ON ____________________________RANGE ONLY
NAME: (Last, First name, print or type): _____________________________________________________
ADDRESS: ___________________________________________________________________________
E-mail address: _____________________________ Phone Number: __________________________
Emergency Phone Number: _____________________ Fax Number: __________________________
_____________________________________________________________________________________

By signing this agreement, I agree to abide by the rules and regulations of the Ben Avery Shooting Facility (BASF) as well as the following:

I hereby make application for a Reserved Range Use Card

	I understand that the prime priority of BASF is SAFETY, and agree to conduct myself with the highest standards for safety for myself and for others.
	I agree to follow all range safety rules including those posted at the range I am using.
	I will be responsible for range safety, range conditions and cleanliness.
	I will leave the range in as good condition as it was upon my arrival.
	I understand that this agreement does not eliminate my liability should an incident occur.
	I understand that the Reserved Range Use Card is issued only for my use and cannot be shared or loaned, and that I do not have permission to allow others to shoot with me.
	I understand that my use of reserved ranges is not part of range scheduling and that my requests to use the range are subordinate to use by registered and scheduled User Groups.
	I understand that I must show this card at the Main Range and sign in to use the range.
	I understand that this procedure only allows me to shoot on the range indicated above and on my card.
	I understand that the BASF does not guarantee a range for my use and that I should call ahead to see if the range is available.
	I understand that the issuance of this card is a privilege and may be revoked by BASF at any time for any abuse of this privilege.
	I acknowledge that I have read and understand the Facility Procedures and all posted safety signs and agree to abide by these.
	I understand that non-compliance with this agreement, rules, procedures, instructions from Rangemasters, or safety violations will result in loss of privileges for reserved range use.

Signature: ______________________________ Date: ___________________