Copy of Student Application

Date *

Which class did you sign up for? *

How did you hear about us? *

Student's First Name *

Students Last Name *

Students date of birth *

Student Email Address *

Country Code

Students Phone Number *

Firearm (Make Model and Caliber)

If applicable* Which brand or type of handgun holster are going to use?

Please upload a photo of the holster you are going to use.

Has the firearm been internally altered in any way? *

Yes
No
Not Applicable

If yes was this work performed by a certified gunsmith or armorer? *

Yes
No
Not Applicable

Unit/Department (If applicable)

Address 1 *

Address 2 *

City *

State *

Zip Code *

Country *

Emergency Contact Name *

Emergency Contact Phone Number *

IN ACCORDANCE WITH ITAR REGULATIONS, ONLY U.S. CITIZENS ARE ACCEPTED TO PARTICIPATE IN VERRETT’S TACTICAL COURSES.

REGISTRANT CANCELLATION POLICY. Verrett’s Tactical requires a non-refundable deposit at the time of enrollment. The remaining balance must be paid in full within 21 days prior to the scheduled training. There will be NO refunds given if a registrant cancels less than 90 days before the training start date. You may reschedule attendance to another available training class at the discretion of Verrett’s Tactical.

CANCELLATION BY VERRETT’S TACTICAL LLC. Verrett’s Tactical reserves the right to cancel the program at any time, with reasonable notice given to all participants. If a program is cancelled, refunds will be paid in full or Verrett’s Tactical LLC may reschedule attendance at the next available training class. In the event of a cancellation, Verrett’s Tactical is not responsible for non-refundable airfares, other airfare penalties, or any other travel charges or expenses you may incur.

I have read and agree to all of the above *

1. Are you under indictment in any court for any felony or any other crime for which a judge may imprison you for more than one year? *

No
Yes

2. Have you ever been convicted in any court of a felony or any other crime for which the judge could have imprisoned you for more than one year even if you received a shorter sentence including probation? *

No
Yes

3: Are you a fugitive from justice? *

No
Yes

4: Have you ever been adjudicated mentally defective or have you ever been committed to a mental institution? *

No
Yes

5: Have you ever been dishonorably discharged from the Armed Forces of United States of America? *

No
Yes

6: Are you an illegal alien in the United States? *

No
Yes

7: Have you ever renounced your United States citizenship? *

No
Yes

8: Have you ever been convicted of a misdemeanor crime or any domestic violence? *

No
Yes

9: Are you subject to a court restraining order for harassing stalking or threatening? *

No
Yes

10: Are you legally prohibited from possessing handling or receiving firearms? *

No
Yes

11: Have you ever been ejected asked to leave or removed from any self defense or firearms training class? *

No
Yes

12: Are you currently or have you ever been part of any street gang terrorist organization or a group who’s purpose is to injure others and/or destroy or violate the U.S. bill of rights and/or the U.S. Constitution? *

No
Yes

I certify that my answers are true correct and complete. I have read and understand the notices and instructions. I understand that a person who answers yes to a question on this form is prohibited from enrolling in a Verrett’s Tactical course. *

1. This Waiver and Acceptance of Liability (“Waiver”) is by and between Verrett’s Tactical LLC and the above listed class participant (“Participant”) prior to the Participant engaging in Verrett’s Tactical Self Defense, Medical, Weapons and or Tactics Training Course’s (“Course”).

2. Verrett’s Tactical LLC is providing the Course for the benefit of Participant and others who desire to train in the use of combat weapons and tactics. Firearms courses involve the use of live ammunition.

3. As with any training involving live ammunition, Verrett’s Tactical will use its best efforts to provide a reasonably safe and effective training environment. However it is impossible to create an absolutely safe environment. Through this Contract, Participant acknowledges this fact and assumes the risks associated with live ammunition training.

1. Participant acknowledges that this online copy of the Verrett's Tactical waiver is 3 pages long and that Participant has read all pages of it. Participant also states that he/she is over 18 years of age. (Under 18 parent signature required)

2. Verrett’s Tactical LLC will allow Participant entry into the Course after Participant agrees to this online waiver and signs the physical Waiver and all terms on the date of the class. Participant acknowledges that the Course, though beneficial, is not a necessity and that similar courses are offered by other entities. Participant is under no physical or economic compulsion from Verrett’s Tactical LLC to engage in this particular Course or to sign this Waiver.

4. Participant expressly acknowledges that training with live ammunition is inherently dangerous and that there is no possible way that Verrett’s Tactical LLC, its employees, or its agents can provide a totally safe environment for the Course. Participant acknowledges that attending and participating in the Course will enhance Participant’s exposure to risk of injury occasioned by carelessness of the Instructor and other Course participants. The Participant risks serious bodily injury and harm that includes a risk of death or dismemberment. Participant hereby assumes the risk of any and all injury (including death) that may result in participation in the Course.

5. Participant hereby absolves Verrett’s Tactical LLC of any damages Participant may experience in participating in the Course. Participant agrees to hold Verrett’s Tactical LLC, its employees, and its agents harmless from any sort of injury or damage experienced by Participant in taking the Course. Participant expressly waives any and all rights and causes of action Participant may have for compensation at law and equity, including negligence, from Verrett’s Tactical LLC, its employees, or its agents in such event that the Participant is injured

6. I agree to allow Verrett’s Tactical LLC, Verrett’s Tactical employees and/or agents to take my picture(s) and videos during class times and use them solely for the purpose of advertisement including FaceBook and other social media, not limited to other web sites. I understand my participation in this course is voluntary.

7. Participant acknowledges that there will be live ammunition fired during Verretts Tactical firearms courses that is not at a hearing safe decibel level. Participant agrees to wear ear and eye protection rated for shooting activities at all times while on the premises/property of the scheduled course. For non firearms related classes participant agrees to wear applicable safety equipment at all times unless otherwise directed by an instructor.

8. This Waiver shall be binding upon Participant, his/her heirs, assigns, administrators, executors and estate. It shall also be interpreted under Idaho State Law.

REQUIRED DOCUMENTS: Copy of current US driverʼs license or valid state ID and (If applicable) Proof of eligibility / Credentials. I agree to email the required documents to Waiver@VerrettsTactical.com before my registered class.

I have read and agree to all of the above *

Copy of Student Application

Emergency Contact

ACCEPTANCE OF LIABILITY

TERMS