I have no criminal convictions that prevent me from legally possessing, owning or purchasing firearms.

I further certify that I have no official or unofficial history of mental illness or substance abuse and that I meet the prerequisites listed for the course.

I further certify I have never been affiliated with or belong to any gang or other illegal  organization involved or engaged in any illegal activities. This includes international or domestic terrorist organizations.

I further certify that my only purpose for seeking the training, which I have requested Black Rifle Training Group (BRTG) to provide me, is so that I may better be prepared to provide lawful service to my employer or in performing lawful acts for my own use.

BRTG programs depend upon the careful control of each student’s cooperation regarding safety issues; therefore, I understand that my instruction may be terminated at any time if my conduct is not deemed satisfactory at the sole discretion of the training staff.

That I will abide meticulously by any and all safety procedures required, and that I agree to sign a statement releasing BRTG from any injury I may sustain during the program.