Shooting Sports Athletic Program Our Shooting Sports welcomes students from any major who express an interest in shooting sports as a recreational or a competitive activity. The team promotes responsible use and ownership of firearms while attempting to further a spirit of competition and community service. RSCC is excited to welcome new shooters for an exciting year. Your success has reached us and has sparked our interest to add you to the program here at Roane State Community College. Due to this year's anticipated amount of participation, students will be expected to earn their spot on this prestigious team. Shooting athletes will represent the school at various competitions across the state and the country. Shooting sports athletes will not be offered any academic or athletic scholarships based on selection and participation the RSCC shooting sports athletic team. Further, each shooting sports athlete must be a Roane State Community College student in good standing and maintain a minimum of a 2.25 grade point average to participate. The vision of the shooting sports teams is to promote continuing interest and competitive aspirations for shooting sports athletes. The shooting sports team will compete at the state, regional and national levels against other collegiate shooting teams. All student athletes are provided an environment that promotes safe and responsible firearm use and are offered the opportunity for instruction, coaching and competition. Shooting Athlete Responsibilities • Maintain good standing by paying shooting fees to the Shooting Sports Range/Facility •Abide by the Range/Facility and Shooting Team rules • Provide one's own firearm and purchase team approved ammunition • Pay range fees and or target fees and ammunition (if purchased from club) before shooting • Prepare, store and clean equipment and facility • Conduct oneself in a safe/appropriate manner at all times **Note: Due to liability issues members, will not be allowed to shoot unless/until shooting coach or designated individuals (club advisor/sponsor, coach/instructor and/or a representative from the range/shooting facility) are present. Shooting Athlete Acknowledgement I have read the above and the Shooting Guidelines and Etiquette page and understand that I assume responsibility to conduct myself in accordance with the Shooting Club rules and guidelines for membership. I acknowledge by my signature that failure to adhere to the rules and guidelines will result in my dismissal from the club and loss of shooting privileges. I understand there are inherent risks in using firearms, and I assume those risks and will not hold the Roane State Community liable for any bodily injury I may suffer in taking part in this activity. Signature _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date Signature (PRINT) _ _ _ __ __ _ _ _ __ _ _ _ _ _ _ __ Phone# _ _ _ _ _ _ _ _ _ e-mail (print) _ _ _ _ _ _ _ _ _ __ Shooting Guidelines and Etiquette The following guidelines are in place to ensure that each participant will have a safe and successful experience. Alcohol and drug use will not be tolerated by any individual participating in RSCC Shooting Sports. Individuals who fail to abide by this will be subject to disciplinary action, loss of shooting privileges and dismissal from the shooting team. Members at all times will abide by and adhere to the Firearms & Other Deadly Weapons section of the Student Code of Conduct, published in the Student Handbook. 1.) Absolutely no inappropriate behavior while on the firing line. Failure to understand and apply the following guidelines could result in injury or worse to yourself and/or others. 2.) All guns must have the action open and contain no live or empty rounds at any time, except while the shooter is on the firing line. A break-open gun's action may be closed when it is in a gun rack, but still shall not contain a live or empty shell. 3.) Shooters must wear eye and ear protection at all times. 4.) Shooters shall place a round of ammunition in their gun only when ready and it is their turn to shoot. 5.) Wait until it's your turn to shoot to load and mount your gun. 6.) ALWAYS walk behind anyone who is on the firing line and be COURTEOUS to others by avoiding any actions that may cause a distraction to those still shooting. ,r General Student-Athlete Information Last Name Sport # 1 First Name Sport #2 (if applicable) Social Security Number Spo11 #3 (if applicable) Grade Birth Date Male Gender Female (circle one) Emergency Contact Information Primary Emergency Contact Last Name Secondary Emergency Contact First Address Address Country Country ____ _ _ (___) Home Phone _ ___ _ _ (_) Work Phone (___) ______ First Last Name (___) ______ _ Home Phone (___) ______ Work Phone (___) ______ Cell Phone Cell Phone l__)_ _ __ L_)_ Beeper Beeper E-mail Address E-mail Address Relation to Student-Athlete Relation to Student-Athlete _ _ _ ' " ' " '= ~ _ _ _,.,,. Medical Information Allergies !._ _ _ _ _ _ _ _ _ _ _ _ 5. _ _ _ _ __ _ __ _ __ 2. _ __ _ _ _ _ _ _ __ _ 4,_ _ _ __ _ _ _ _ _ _ _ 6. ------------ Current Medications !._ _ _ _ __ _ _ _ _ __ 2. - - - - - -- - - - - - 3. _ _ __ __ _ _ _ _ _ _ Insurance Information Primary Insurance Secondary Insurance Company Company Address Address L _ )_ _ _ __ Phone Number L _ ) _ _ _ __ Phone Number Plan Number Plan Number Po licy Number Policy Number Policy Holder Policy Holder Last Name First Last Name First ID Number ID Number Bi11h Date Birth Date Type Type Primary Care Physician Primary Care Physician Primary Care Physician Phone Number Primary Care Physician Phone Number