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Parental Consent for Participants Under 18

I, of , , hereby certify that I am the parent/legal guardian of, * Child's Date of Birth : , a minor, and I hereby give my consent for the minor to participate in activities at White Birch Ammo, LLC d/b/a White Birch Armory. I have read and understand the terms of the "WBA Range Waiver & Release of Liability", and I agree to be bound by all its provisions on behalf of the minor. I further acknowledge that I have discussed the risks involved with the minor, and they understand the inherent dangers associated with firearms.

*A unique email address is required for all participants signing waivers. The waiver system relies on email address as a unique identifier for each contact record.

SAFETY RULES

MUZZLE MANAGEMENT: Always keep your muzzle pointed in a safe direction (downrange when on the range).
TRIGGER FINGER CONTROL: Always keep your finger off the trigger until your muzzle is on target and you are ready to fire.
Treat all firearms as though they are loaded. When clearing always check visually and physically to confirm it is unloaded. Always understand the status of your equipment.
Be sure of your target and what is beyond/around it.
Hearing protection and wrap around eye protection are always required to be worn while firing. Open toed footwear and low-cut attire is not permitted.
Follow any additional safety guidance provided by instructors and range staff.
You are expected to use good judgment, and to refrain from attempting any exercise, which you may not be able to perform safely, based upon your own ability, equipment, prior training or physical condition.
Everyone has the responsibility for range safety. If you see something wrong, immediately notify range staff.
Do you have any physical disability, limitation, allergy, illness or other condition that would affect your ability to participate safely in any aspect of this program?
YesNo
(If yes, see instructor)
Are you under the influence of any prescription/nonprescription drug or alcohol that would influence your safe participation in any aspect of this program?
YesNo
(If yes, see instructor)
You are responsible for any damage to yourself, property, or persons by your misuse of firearms or your actions while on White Birch Armory’s premises. You will be charged $35 per hit after the first hit to the retriever.
Prior to handling any firearm with which you are unfamiliar, you must notify instructors or range staff.

Emergency Contact Information:

Name: Phone Number:

I ACKNOWLEDGE THAT:

I HAVE READ, UNDERSTAND, AND AGREE TO FOLLOW AND BE BOUND BY ALL RANGE RULES, POLICIES, TERMS AND CONDITIONS OF WHITE BIRCH AMMO, LLC. All rules, policies, terms and conditions can be found in their entirety at wbarmory.com or be provided upon request at the Information Desk.
I HAVE READ AND UNDERSTAND THE RANGE SAFETY RULES AND GUIDELINES.

IN WITNESS WHEREOF, the undersigned does hereby execute this document on this

September 7, 2026

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