Register for Firearm Cleaning Course

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We are looking forward to having you join us for our upcoming women-only firearm cleaning class. First, we’d like to get some essential information.

Name*

First Last

Address*

Street Address City State ZIP Code

Email*

Cell*

What firearm will you be cleaning?

Let us know what firearm you’re planning on bringing so we can make sure that it is easily cleaned without special tools!

Who makes your firearm?

E.g. Smith & Wesson, Glock, SIG, CZ, etc. It should be engraved on the firearm, typically on the slide.

What is the model of your firearm?

e.g. M&P 2.0, Glock 19, P365, Shadow 2, etc. It should also be engraved on the firearm slide

Special needs

What special needs should we be aware of? Enter (arthritis, injury, disability or NONE) below. We will do our best to accommodate special physical needs.

Groups

We welcome groups. Please click “Yes” under Group attendees below and enter in the email address of each of the other members of the group who will be attending with you. Then fill out payment information below. After you submit payment, the group members will receive a link to this page; all group members need to fill out their information and sign waivers.

Group attendees

Yes

Registration Fee*

Price:

Registration Fee

Price:

Total Number of Attendees

Attendee 2 email address*

Attendee 3 email address*

Attendee 4 email address*

Attendee 5 email address*

Attendee 6 email address*

Attendee 7 email address*

Attendee 8 email address*

Attendee 9 email address*

Attendee 10 email address*

Attendee 11 email address*

Attendee 12 email address*

Attendee 13 email address*

Attendee 14 email address*

BarrelBlok

If you don’t already have a BarrelBlok (given out at our recent Home Defense classes, please add one to the cart for each person attending. With the BarrelBlok, the firearms are rendered safe because there is no possibility of any rounds being chambered while we’re cleaning them.

BarrelBlok

Price: $15.00

Enter the number of BarrelBloks you’d like to purchase, or leave blank for none (Required for each attendee)

Cleaning Kits

You’re more than welcome to bring your own cleaning kit. Or, you’re welcome to purchase one of ours.

We have a basic cleaning kit that comes with all the basics and nothing frivolous. It contains a Bore Snake, a healthy handful of Q-tips to remove dirt and oils from tighter spaces, the best all-in-one cleaner and lubricant we’ve found, and a very good cleaning rag. It is the perfect size to fit into the zippered cleaning kit bag that comes with the Heroine Range Bag!

Cleaning Kits

Price: $15.00

Enter the number of cleaning kits you’d like to purchase, or leave blank for none

Refunds-READ THIS-It’s really important

We’ll gladly refund your fees if we cancel the class. Otherwise, because we have to pay our instructors in advance, we cannot allow rescheduling or refunds. We do this as a labor of love to help women and cancellations prevent us from doing so.

Certification

I certify that:

I am not under the influence of any prescription or other drug/substance that may impair my ability in any way during the course

I can legally handle firearms AND I am a US citizen or lawful permanent resident (green card holder), refugee, or have been granted asylum

I have no criminal convictions, am not currently under indictment or prosecution for any offense; nor am I wanted for questioning or arrest by any law enforcement or government agency

I will follow proper safety procedures (especially if I am pregnant) in the handling and cleaning of firearms

I have read and will sign the participation waiver agreement

I understand that Adventure Protection reserves the right to refuse instruction and expel any student that creates an unsafe situation for any of the instructors or participants

Coupon

Total

Credit Card

Card Details

Cardholder Name

Release, Waiver, Indemnification, Hold Harmless, and Assumption of Risk Agreement

WHEREAS, in return for instruction in firearms, use of premises, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Undersigned agrees to the following:
The Undersigned grants Adventure Protection, Inc. and its assigns, a non-exclusive, royalty-free license to use images of the Undersigned obtained during the class. This license gives “Adventure Protection” rights to use the images for promotional purposes such as but not limited to brochures, flyers, posters, and the posting on “Adventure Protection’s” website or social media accounts.
The Undersigned agrees to indemnify, hold harmless and defend Curtis Bingham, Adventure Protection, the Premise owner, and any of its employees, volunteers, instructors, officers, (hereinafter collectively referred to as Adventure Protection) from any and all fault, liabilities, costs, expenses, claims, demands or lawsuits arising out of, related to, or connected with: the discharge of firearms; the course of instruction; the Undersigned’s participation in the course of instruction, the Undersigned’s presence on or use of the range, buildings, land and premises (“Premises”); and any and all acts or omissions of the Undersigned.
And should any such claim, demand or lawsuit arise or be asserted in any way or form whatsoever related thereto, whether arising under the laws of the United States or of any State, or under any theory of law or equity, the Undersigned will indemnify, hold harmless and defend Adventure Protection, from any and all costs, expenses or liability including, but not limited to, the cost of any settlement or judgment made or rendered against Adventure Protection, whether individually, jointly, or in solido with the Undersigned, together with all costs of court and other costs or expenses incurred in connection with any such claim, demand or lawsuit, including attorney’s fees.
The Undersigned furthermore waives for herself and her executors, administrators, assignees, heirs and next of kin, any and all rights and claims for damages, losses, demands and any other actions whatsoever, which she may have or which may arise against Adventure Protection, (including, but not limited to any and all injuries, damages or illnesses suffered by the Undersigned or Undersigned’s property), which may, in any way whatsoever, arise out of, be related to, or be connected with: the course of instruction; the Premises, including any latent defect in the Premises; the Undersigned’s presence on or use of said Premises; Undersigned’s property (whether or not entrusted to Adventure Protection); and, the discharge of firearms. Adventure Protection shall not be liable for, and the Undersigned, on behalf of herself and her executors, administrators, assignees, heirs and next of kin, hereby expressly releases Adventure Protection, the Premise owner, or the NRA from any and all such claims.
The Undersigned hereby expressly assumes the risk of entering the Premises and of taking part in activities on the Premises which include, but are not limited to, instruction in the use of firearms, the discharge of firearms and the firing of live ammunition. The Undersigned furthermore hereby acknowledges and agrees that she has read, understands and will at all times abide by all Adventure Protection safety, range rules, procedures, and any other rules or procedures stated by the instructor.
The Undersigned expressly agrees that this instrument is intended to be as broad and inclusive as permitted by law, and that if any provisions of this instrument is held invalid or otherwise unenforceable, the enforceability of the remaining provisions shall not be impaired thereby. This instrument binds the Undersigned and his/her executors, administrators, assignees, heirs and next of kin.
Signing this form is voluntary. However, registration acceptance is dependent on signature.

Signature*

Please use your mouse (or finger if on a mobile device) to sign the form. Try to color inside the lines just this once!