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40 <br />as <br />ACKNOWLEDGMENT OF LIABILITY FOR FIRING WEAPON <br />I, , hereby acknowledge <br />and agree that I shall be solely responsible for any result <br />attributable to my firing of a weapon in connection with the <br />Indian River County Concealed Weapons License Application <br />Procedure. I hereby further agree to hold harmless and indemnify <br />Indian River County, and any agency or organization conducting <br />said course, and their officers and employees, from any and all <br />liability for property damage, personal injury or loss of life <br />resulting from my use of the weapon, and I shall defend against <br />any claim or cause of action made against the above mentioned <br />parties, or their officers and employees, which may arise from my <br />use of the weapon. <br />Applicant <br />Date: <br />(THIS FORM IS TO BE EXECUTED AND TURNED INTO THE INSTRUCTOR PRIOR <br />TO THE RANGE PORTION OF THE COURSE.) <br />-5- <br />