Michigan Concealed Pistol License (CPL) Course

Firearm Use and Rental Agreement is below, this agreement will require your signature if renting a firearm. We will have these forms available at the range.

PEACE OF MIND DEFENSE TRAINING llc

Firearm Use and Rental Agreement

Initial each declaration. If you cannot make each declaration you are prohibited from bringing onto or using firearms on the range. 

I declare that: 

(1) I have not been convicted of a felony.________ 

(2) I have not been convicted in any court of a misdemeanor crime of domestic violence.________ 

(3) I have not sold firearms to or otherwise disposed of firearms to any person that I have reasonable cause to believe has been convicted of a misdemeanor crime of domestic violence.________ 

(4) I am not a fugitive from justice.________ 

(5) I have not been convicted in any court of possession, use, or sale of marijuana or narcotic drugs.________ 

(6) I am not presently declared mentally incompetent and I am not presently committed to any mental institution.________ 

I understand that making a false statement is a crime. I certify that all information on this form is true and correct. 

Signatories of this form further certify that they will comply with the Domestic Violence Amendment to the Gun Control Act of 1968, MIlitary regulations, local regulations and local and state laws on ownership, possession, registration, transportation and safe use of privately owned firearms and ammunition. 

1. Guest or Renter’s Printed Name_______________________________________ 

2. Guest or Renter’s Signature __________________________________________

3. Date __________________________

4. Sponsor’s Printed Name ________________________________

5. Sponsor’s Signature ____________________________________

6. Date __________________________

Request the individual listed on line 1 of this form be rented the following item(s) on line(s) 7-10 from Peace Of Mind Defense Training, for the date of _________/_________/____________________. 

I understand this equipment is not to leave the range. 

I understand it is my responsibility to ensure firearms are clear and in safe condition prior to returning to POMDT. 

I understand all normal equipment checkout fees are due before the equipment is checked out. Service fees will be comparable to the replacement cost of the item(s) when such item(s) are not returned by the undersigned. 

By affixing my signature on line 14 of this form, I am certifying I received the item(s) listed in line(s) 7-10, I inspected each item, and it was clean and serviceable, except as noted. I acknowledge I am responsible for any damage other than fair wear and tear and agree to pay such charges when the item(s) are returned. 

      Description       Serial #      Fee        Time Out/initials     Time In/Initials  

7.  _____________  _________  ________   _______________   _______________

8.  _____________  _________  ________   _______________   _______________

9.  _____________  _________  ________   _______________   _______________

10. _____________  _________  ________  _______________   _______________

RELEASE AND HOLD HARMLESS AGREEMENT

The undersigned being desirous of renting and using the items(s) listed on this agreement from Peace Of Mind Defense Training, llc, (POMDT), does hereby and, as an inducement to the said above POMDT to allow the use and rental of such item(s) to the undersigned, forever release, acquit and discharge said POMDT from any and all cause or causes of action, including personal injury, illness, death and property damage costs, charges, claims, demands and liabilities of whatever kind, name or nature in any manner arising out of the enjoyment/use and control over said item(s). 

This release is intended to cover all injuries, fatal or nonfatal, and illness of every nature and personal property damage, if any, which may or might be sustained or suffered from any cause whatsoever connected with or arising from or by reason of use of said item(s). 

The undersigned further agrees he/she will indemnify and will hold harmless POMDT from any and all costs, charges, claims, demands and liabilities of any kind arising from the improper or negligent use by the undersigned of said item(s) or arising from the willful or negligent acts of the undersigned. 

The undersigned agrees he/she will exercise reasonable care in the use of said item(s) and will return the same to POMDT in the same condition in which it was received from POMDT.

 I have received, read and fully understand the Firearm Safety Briefing for the firearm(s) listed on this rental agreement. 

11. Renter’s Printed Name: _____________________________________________ 

12. Drivers License # : _________________________ 

13. Expiration Date : ___________________________

14. Renter’s Signature: ________________________________________________

15. Date: ___________________________________

16. POMDT Official’s Printed Name: _______________________________________

17. POMDT Official’s Signature: __________________________________________

18. Date: ___________________________________