click on the button below to print out the new member application packet
Click on button Text below to print extra shooters waivers
(All Shooters including all guests must have waiver on file for the calendar year)
(All Shooters including all guests must have waiver on file for the calendar year)
Please Call 618-922-9657 for membership info.
Memberships run from April to April each year.
Please read, intial, fill out, and print the forms below to obtain your membership
Rules and Regulations
updated 4/20/15
1. Always treat firearms as if they are loaded.
2. Firearms will be unloaded prior to entering, and leaving the range with slides locked
back, and cylinders kept open. (except conceal carry permit holders)
3. Never put your finger on the trigger until you are ready to shoot.
4. Always be certain of your target and backstop before firing.
5. All shooters must be wearing Ear & Eye Protection before entering the range.
6. Firearms will stay in the assigned shooting lane at all times.
7. A maximum of Two shooters allowed per lane, observers not allowed in the range.
8. Firearms on the firing line will be pointed directly down-range at all times.
9. It is EVERYONE'S RESPONSIBILITY to make sure the firing line is SAFE before ANYONE goes
forward on the Firing line, FOR ANY REASON. NO EXCEPTION'S !
10. All brass must be swept up and deposited in the marked container.
11. Shooters who deliberately shoot the range baffles, supports,or target holders will be charged for the damage and may be Barred from the Range.
12. Anyone believed to be under the influence of alcohol or drugs will be refused use of the
range, and asked to leave the premises immediately.
13. Shooters under the age of 21, must be accompanied by an adult while on the range.
or accompanied by a valid Illinois F.O.I.D Card holder.
14. Be Courteous To Other Members Using The Facility.
15. Always Error On the Side Of Caution Regarding Safety Practices. “When In Doubt, Don’t”.
16.ABSOLUTELY NO AUTOMATIC FIREARMS! THIS INCLUDES ANY FIREARMS WITH ENHANCE TRIGGERS MADE TO SIMULATE AUTOMATIC FIRE!
17. Must have Membership card with Guest pass listed on card (when Guest are present) and valid Illinois F.O.I.D Card on your person at all times while on the range!
18. The Pond Creek Shooting Range Officers and other administrative and operating personnel are not responsible for accidents, injury, and personal property theft or damage occurring on club grounds.
19. No tracer, incendiary, or armor-piercing ammunition, nor illegal explosive devices are allowed on club grounds.
20. Range maintenance and mowing take precedence over all shooting activities.
21. all guests must stay with member at all times.
22. if members are waiting to shoot guest must shoot from members lane only.
23. only shoot at target boards provided by the range ! no trash targets or ground targets are permitted.
24. Absolutely no Rifle fire bigger than 22.cal at Pistol Range
25. always move PVC legs with target boards when adjusting to different yardage lanes
26. we close the week of both Shotgun Deer Seasons
27. there is Absolutely no soliciting anywhere on the grounds of Pond Creek Shooting Range
28. we reserve the right to refuse service to anyone for any reason
29. All Shooters must have a waiver on file with Pond creek Shooting Range for the membership calendar year this includes all guests if your not sure please sign another one!
If any of the above rules are violated, you will be asked to leave the range immediately.
updated 4/20/15
1. Always treat firearms as if they are loaded.
2. Firearms will be unloaded prior to entering, and leaving the range with slides locked
back, and cylinders kept open. (except conceal carry permit holders)
3. Never put your finger on the trigger until you are ready to shoot.
4. Always be certain of your target and backstop before firing.
5. All shooters must be wearing Ear & Eye Protection before entering the range.
6. Firearms will stay in the assigned shooting lane at all times.
7. A maximum of Two shooters allowed per lane, observers not allowed in the range.
8. Firearms on the firing line will be pointed directly down-range at all times.
9. It is EVERYONE'S RESPONSIBILITY to make sure the firing line is SAFE before ANYONE goes
forward on the Firing line, FOR ANY REASON. NO EXCEPTION'S !
10. All brass must be swept up and deposited in the marked container.
11. Shooters who deliberately shoot the range baffles, supports,or target holders will be charged for the damage and may be Barred from the Range.
12. Anyone believed to be under the influence of alcohol or drugs will be refused use of the
range, and asked to leave the premises immediately.
13. Shooters under the age of 21, must be accompanied by an adult while on the range.
or accompanied by a valid Illinois F.O.I.D Card holder.
14. Be Courteous To Other Members Using The Facility.
15. Always Error On the Side Of Caution Regarding Safety Practices. “When In Doubt, Don’t”.
16.ABSOLUTELY NO AUTOMATIC FIREARMS! THIS INCLUDES ANY FIREARMS WITH ENHANCE TRIGGERS MADE TO SIMULATE AUTOMATIC FIRE!
17. Must have Membership card with Guest pass listed on card (when Guest are present) and valid Illinois F.O.I.D Card on your person at all times while on the range!
18. The Pond Creek Shooting Range Officers and other administrative and operating personnel are not responsible for accidents, injury, and personal property theft or damage occurring on club grounds.
19. No tracer, incendiary, or armor-piercing ammunition, nor illegal explosive devices are allowed on club grounds.
20. Range maintenance and mowing take precedence over all shooting activities.
21. all guests must stay with member at all times.
22. if members are waiting to shoot guest must shoot from members lane only.
23. only shoot at target boards provided by the range ! no trash targets or ground targets are permitted.
24. Absolutely no Rifle fire bigger than 22.cal at Pistol Range
25. always move PVC legs with target boards when adjusting to different yardage lanes
26. we close the week of both Shotgun Deer Seasons
27. there is Absolutely no soliciting anywhere on the grounds of Pond Creek Shooting Range
28. we reserve the right to refuse service to anyone for any reason
29. All Shooters must have a waiver on file with Pond creek Shooting Range for the membership calendar year this includes all guests if your not sure please sign another one!
If any of the above rules are violated, you will be asked to leave the range immediately.
One Year Membership with guest pass $200.00
Annual Family Pass up to four Immediate Family Members With Guest Pass $250.00
(Lifetime Memberships are Available)
Pond Creek Shooting Range, LLC.
www.pondcreekshootingrange.com
Thank you for your interest in applying for or renewing your membership with Pond Creek Shooting Range, LLC. Our memberships run from April till April annually.
In order to keep our membership records current and accurate we need hard copies of information from you. Enclosed you will find a Membership Application/Information Sheet and a 2 page annual Waiver form. Please complete these documents and return them along with the required photocopy of your current FOID card (Illinois residents). These annual requirements must be met for all members including our Lifetime Members. If paying by check please make sure your check is payable to Pond Creek Shooting Range and include it with the enclosed paperwork. Membership payment amounts and options are also enclosed. If you have any questions please feel free to contact me at [email protected] or contact me directly at 618-922-9657 and leave a brief message.
Thank you,
William H Haseker
Director of Operations
Checklist for Renewal/Application documents:
□ Membership Application/Information filled out and signed
□ Signed Waiver
□ Payment /valid FOID card
Pond Creek Shooting Range,LLC
MEMBERSHIP APPLICATION/INFORMATION ( New)( Renewal) circle one
Please print clearly all information except for the required member signature
Name:____________________________________ Home Phone:____________________________ Cell Phone:________________________
Address:__________________________________ City:_____________________________________
State:__________ Zip code:_________________
E-MAIL:__________________________
DOB:______________
IL FOID # ________________________
IL FOID EXPIRATION DATE:___________
EMERGENCY CONTACT NAME:______________________
RELATIONSHIP:_______________________
EMERGENCY CONTACT PHONE:______________________
APPLICANT SIGNATURE:______________________________________________
Date:_____________
Please mark one:
New member fee with Guest Pass: $200.00 ____
Family Membership: (up to 4 immediate family members) with guest pass $250.00 _____
Life Time Membership : $4500.00 _____
Life Time: (with Guest Pass) $5500.00____
IL residents Must have a FOID card to become a member.
Note you must submit a copy of your valid FOID card to the Pond Creek Shooting Range operations board before your key will be issued and /or Membership renewed.
I hereby make application for membership in the Pond Creek Shooting Range LLC. and agree to conform to its By-laws and Amendments and subscribe to all Safety Rules
I certify that I have read the Pond Creek Shooting Ranges Regulations & Range Safety Rules.
I further certify that I agree to abide by these Regulations and Safety Rules at all times
Signature:__________________________________
Please Print name:____________________________
This application approved by the Pond Creek Shooting Range LLC:
Date:__________________________ Secretary________________________________
Please fill out the above Membership Application along with Membership fees and return to
Pond Creek Shooting Range, LLC
P.O. Box 24
Freeman Spur, Illinois 62841
RELEASE,
INDEMNIFICATION AND HOLD HARMLESS AGREEMENT.
In consideration of participating in gun club or hunting activities, and for other good and valuable consideration, I hereby agree to release and discharge from liability arising from negligence Pond Creek Shooting Range LLC and its owners, directors, officers employees, agents, volunteers, participants, and all other persons or entities acting for them (hereinafter collectively referred to as “Releasees”), on behalf of myself and my children, parents, heirs, assigns, personal representative and estate, and also agree as follows:
1. I acknowledge that gun club or hunting activities involve known and unanticipated risks which could result in physical or emotional injury, paralysis or permanent disability, death, and property damage. Risks include, but are not limited to, death or serious injury as a result of being shot or as a result of equipment malfunction; hearing loss; loss of vision; broken bones, bruises and other bodily injuries caused by falls; medical conditions resulting from physical activity, and damage clothing or other property. I understand such risks simply cannot be eliminated, despite the use of safety equipment, without jeopardizing the essential qualities of the activity.
2. I expressly accept and assume all the risks inherent in this activity or that might have been caused by the negligence of the Releasees. My participation in this activity is purely voluntary and I elect to participate despite the risks. In addition, if at any time I believe that event conditions are unsafe or that I am unable to participate due to physical or medical conditions, then I will immediately discontinue participation.
3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Releasees from any and all claims, demands, or causes of action which are in any way connected with my participation in this activity, or my use of their equipment or facilities, arising from negligence. This release does not apply to claims arising from intentional conduct. Should Releasees or anyone acting on their behalf be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold harmless for all such fees and costs.
4. I represent that I have adequate insurance to cover any injury or damage I may suffer or cause while participating in this activity, or else I agree to bear the cost of such injury or damage myself. I further represent that I have no medical or physical condition which could interfere with my safety in this activity, or else I am willing to assume-and bear the costs of – all risks that may be created, directly or indirectly, by any such condition.
5. In the event that I file a lawsuit, I agree to do solely in the state where Releasees’ facility is located, and I further agree that the substantive law of the state shall apply.
6. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.
By signing this document, I agree that if I am hurt or my property is damaged during my participation in this activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim of negligence.
I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to me or that the cost to engage in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to participate at the stated cost in return for execution of this release is a reasonable bargain.
I have read and understood this document and I agree to be bound by its terms.
Signature_____________________________ Print name______________________________
Address__________________________________________________City____________________ State_________
Zip_____________ Telephone (___)____________________ Date_____________________________
PARENT OR GUARDIAN ADDITIONAL AGREEMENT
(Must be completed for participants under the age of 18)
In consideration of_______________________________________________(PRINT minor’s name) Being permitted to participate in this activity, I further agree to indemnify and hold harmless Releasees from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor.
Parent or Guardian____________________________________
Print Name__________________________________ Date__________________________________
BELOW FOR CLUB USE ONLY*********************************
PAYMENT: CLUB DUES $ _________________
TOTAL $ _____________________
MEMBERSHIP TYPE: REGULAR FAMILY DATE PAID: __________________
Pond Creek Shooting Range REPRESENTATIVE SIGNATURE: ___________________________________
DATE: ___________________
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In consideration of participating in gun club or hunting activities, and for other good and valuable consideration, I hereby agree to release and discharge from liability arising from negligence Pond Creek Shooting Range LLC and its owners, directors, officers employees, agents, volunteers, participants, and all other persons or entities acting for them (hereinafter collectively referred to as “Releasees”), on behalf of myself and my children, parents, heirs, assigns, personal representative and estate, and also agree as follows:
1. I acknowledge that gun club or hunting activities involve known and unanticipated risks which could result in physical or emotional injury, paralysis or permanent disability, death, and property damage. Risks include, but are not limited to, death or serious injury as a result of being shot or as a result of equipment malfunction; hearing loss; loss of vision; broken bones, bruises and other bodily injuries caused by falls; medical conditions resulting from physical activity, and damage clothing or other property. I understand such risks simply cannot be eliminated, despite the use of safety equipment, without jeopardizing the essential qualities of the activity.
2. I expressly accept and assume all the risks inherent in this activity or that might have been caused by the negligence of the Releasees. My participation in this activity is purely voluntary and I elect to participate despite the risks. In addition, if at any time I believe that event conditions are unsafe or that I am unable to participate due to physical or medical conditions, then I will immediately discontinue participation.
3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Releasees from any and all claims, demands, or causes of action which are in any way connected with my participation in this activity, or my use of their equipment or facilities, arising from negligence. This release does not apply to claims arising from intentional conduct. Should Releasees or anyone acting on their behalf be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold harmless for all such fees and costs.
4. I represent that I have adequate insurance to cover any injury or damage I may suffer or cause while participating in this activity, or else I agree to bear the cost of such injury or damage myself. I further represent that I have no medical or physical condition which could interfere with my safety in this activity, or else I am willing to assume-and bear the costs of – all risks that may be created, directly or indirectly, by any such condition.
5. In the event that I file a lawsuit, I agree to do solely in the state where Releasees’ facility is located, and I further agree that the substantive law of the state shall apply.
6. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.
By signing this document, I agree that if I am hurt or my property is damaged during my participation in this activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim of negligence.
I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to me or that the cost to engage in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to participate at the stated cost in return for execution of this release is a reasonable bargain.
I have read and understood this document and I agree to be bound by its terms.
Signature_____________________________ Print name______________________________
Address__________________________________________________City____________________ State_________
Zip_____________ Telephone (___)____________________ Date_____________________________
PARENT OR GUARDIAN ADDITIONAL AGREEMENT
(Must be completed for participants under the age of 18)
In consideration of_______________________________________________(PRINT minor’s name) Being permitted to participate in this activity, I further agree to indemnify and hold harmless Releasees from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor.
Parent or Guardian____________________________________
Print Name__________________________________ Date__________________________________
BELOW FOR CLUB USE ONLY*********************************
PAYMENT: CLUB DUES $ _________________
TOTAL $ _____________________
MEMBERSHIP TYPE: REGULAR FAMILY DATE PAID: __________________
Pond Creek Shooting Range REPRESENTATIVE SIGNATURE: ___________________________________
DATE: ___________________
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