JOHNSTON COMMUNITY COLLEGE RANGE REQUEST FORM REQUESTING AGENCY: DATE REQUESTED: TIME REQUESTED: ANTICIPATED CLASS SIZE: RANGE REQUESTED: (CHECK ALL THAT APPLY) MOBILE CLASSROOM RIFLE RANGE PISTOL RANGE SHOOT HOUSE (see information below regarding Shoot House reservations) Weapon Type: Rubber Blue Training Guns Simunition (non-lethal) Weapons Duty Weapon (Live-Fire) Agency Instructor: NOTES: Request are processed and confirmed on a first come, first served basis. You will receive a confirmation via email once reservations have been added to the range calendar. All range request are to be submitted via email to Dr. Jamie Wicker at jfwicker@johnstoncc.edu and submitted at least 3 business days prior to requested date of training. All shoot house instructors must possess a current Specialized Firearms Instructor Certificate, current CPR card, and a Shoot House Instructor Course Certificate. Please attach documentation to this request.
A minimum of 10 students are required to utilize the shoot house and a minimum of two certified shoot house instructors are required. Two certified shoot house instructors may include one(1) departmental instructor and one(1) Johnston Community College instructor. If a department is unable to provide a certified shoot house instructor, sufficient number of students to justify two Johnston Community College instructors are required. Sufficient number of students will be determined based on class hours, instructor cost, and equipment cost. All live-fire training using the shoot house MUST be run as a class by Johnston Community College. NO EXCEPTIONS! The Johnston Community College Instructor has final authority over any training involving the shoot house, rifle range, and pistol range. A minimum of 10 students are required to utilize the shoot house and one Johnston Community College shoot house instructor is required if no live-fire training is planned. NO EXCEPTIONS! A lesson plan is required for training involving live-fire in the shoot house and is to be submitted at time of request. Please attach to this request. Layout of shoot house is available upon request.
RANGE RULES Safety is the most important component of training. Everyone is responsible for safety. Do not leave the range (stay in designated area and out of parking/other areas) unless approved by the Firearms Instructor. Electronic devices including, but not limited to cell/smart phones, computers and cameras are prohibited on the range. Participants shall secure all electronic devices in their vehicles or other secure location during firearms training. Do not touch or handle any firearm, ammunition, or equipment during this training except as specifically directed by the Firearms Instructors. Always treat firearms as if they are loaded. Keep the muzzle of the firearm pointed in a safe direction at all times. Safety on, if equipped, except when firing. Mechanical safety features are not a substitute for the safe carry, handling, and use of a firearm. Finger off the trigger and outside the trigger guard except when firing. Positively identify the target. Positively identify what will stop the bullet. Fire only on command of the Firearms Instructor. Do not bend over to pick up a dropped/grounded item with a firearm in hand and without command to do by Firearms Instructor In an emergency, anyone (instructor or student) may call cease fire. During cease fire keep the firearm secure and pointed in a safe direction and wait for the Firearms Instructor s command. Follow all lead safety precautions. Instructors/participants shall wear hats at all times on the range including, but not limited to range preparation, dry-fire, live-fire, picking up brass, and range cleanup. Instructors/participants may remove hats when off the range during periods when the instructor/participant is not subject to lead exposure. Do not carry/eat/drink food or water on the range. Wash hands as soon as practical after handling firearms, ammunition, or spent cartridges. All safety procedures and practices must be followed at all times.
Live-fire targets should be limited to bullet traps inside the shoot house. No targets affixed to the walls of the shoot house. This will extend the life of the facility and reduce maintenance. Bullet trap door is to be used, when necessary, to stop rounds that may exit through the unprotected front door. Personal Protective Equipment including, but not limited to safety glasses, adequate hearing protection, and billed cap, is to be worn while on the range. Ballistic helmets must be worn while conducting training inside the Shoot House. NO EXCEPTIONS! This includes instructors and students. Spent brass should be policed, trashed collected and disposed of, and equipment returned to storage prior to leaving the range. Emergency plan is to be reviewed prior to any training involving the Ranges and Shoot House. Emergency plan should include a plan of action in the event an emergency occurs. One person should be the dedicated gate key holder and tasked with ensuring the front gate is open for evacuation. First Aid Kit is located in storage connex on site.
MEDICAL EMERGENCY PLAN Johnston Community College Training: Date: Medical Emergency Plan is to be completed by instructors prior to training session. Emergency Plan and Range Rules should be delivered to trainees during safety briefing prior to training session. In the event anyone requires first aid or medical assistance during this training, the following actions will be taken (communication, transportation, and trauma bag must be located at the range and immediately available). The Firearms Instructor will immediately call for a ceasefire, direct trainees to secure all weapons in a safe manner, and step back from the area on the range. The Trauma Bag s confirmed location: Instructor/Trainee: will immediately obtain the Trauma Bag and AED, if available, and provide care (First Aid and CPR) as necessary. Instructor: will immediately initiate EMS via county/state radio system or by dialing 911 and provide information about the victim to the telecommunicator. Instructor/Trainee: is responsible for ensuring the front gate at Howell Woods is open to allow EMS access to range facility. Instructor/Trainee should have gate key on his/her person for duration of training. Gate Key should be returned to JCC Representative at the conclusion of training. Instructor: will transport the injured person to the nearest hospital, if directed by the 911 dispatcher or if 911 cannot be contacted. Do NOT transport victim against the directions of 911 dispatcher. The hospital will be Johnston Health. Driving directions are included to this action plan. Instructor: will obtain a written statement from any witnesses who may have knowledge of the incident. This instructor will also collect all evidence that may have been a factor in the incident (weapon, ammunition, body armor, other). Instructor: will report the incident to Dr. Jamie Wicker, Dean of Transportation and Public Safety, as soon as practical, but not later than fifteen minutes after the victim receives care and/or is transported to the hospital whichever occurs first.
MEDICAL EMERGENCY PLAN Johnston Community College Instructor 1: Department/Agency: Signature: Instructor 2: Department/Agency: Signature: Instructor 3: Department/Agency: Signature:
Driving Directions from Howell Woods to Johnston Health Leaving HW, turn right and head northwest on Devils Racetrack Rd. Turn right to merge onto I-95 N Take exit 95 for 70 Bus/Market St. Turn left onto 70 Bus/Market St. Turn right onto N Brightleaf Blvd Turn left onto Hospital Rd. Emergency Entrance is on your left.
ACKNOWLEDGEMENT OF RISK, RELEASE &INDEMNITY AGREEMENT Johnston Community College Howell Woods (Shoot House and Firing Range) I,, a sworn law enforcement agent with Agency hereby acknowledge and authorize that I have voluntarily applied to enter on to and to engage in or to observe shooting and other activities at the Howell Woods/Johnston Community College weapons firing range and/or shoot house. Agency will provide a current Law Enforcement Specialized Firearms Instructor and/or certified Shoot House Instructor for instruction. I ACKNOWLEDGE AND UNDERSTAND THAT SHOOTING ACTIVITIES ARE INHERENTLY HAZARDOUS and involve both known and unanticipated risks which could result in damage or destruction of property and physical or emotional injury, including paralysis or death, of myself or of other persons. I understand that such risks cannot be eliminated without compromising the essential qualities of shooting activities. INITIAL I FURTHER ACKNOWLEDGE AND UNDERSTAN THAT the nature and condition of the RANGE facilities, premises and environment is such that both known and unanticipated hazards exist which create or contribute to both known and unanticipated risks inherent in entering on to the RANGE, in using RANGE facilities and in engaging in or observing any activities of any kind whatsoever while at the RANGE. I understand that such hazards and risks cannot be eliminated without compromising the essential qualities of the RANGE facilities, equipment, premises, and environment. INITIAL I FURTHER ACKNOWLEDGE AND UNDERSTAND THAT Johnston Community College has no duty to undertake first-aid or rescue operations or procedures in the event any such property damage or physical or emotional injury occurs, and that any such operations or procedures may result in compounded or increased damages or injuries. INITIAL As lawful consideration for being permitted by Johnston Community College to use the RANGE, I agree to the following: I EXPRESSLY AGREE TO ACCEPT AND ASSUME ANY AND ALL RISKS AND RESPONSIBILITES EXISTING ON THE RANGE AND SHOOT HOUSE AND IN ENTERING ON TO THE RANGE AND IN USING RANGE FACILITES, EQUIPMENT INCLUDING DRIVEWAYS, ROADWAYS, LAND, AND GENERATOR OWNED BY JOHNSTON COMMUNITY COLLEGE. INITIAL I AGREE to assume all responsibilities and liability for any act or acts, even any negligent, reckless or criminal act or omission to act of my agency s employees at the RANGE. INITIAL I have carefully read this Acknowledgement of Risk, Release, & Indemnity Agreement and fully know its contents. I acknowledge that no other inducement, assurance or guarantee has been made to me in consideration of my signing this Agreement, which I sign voluntarily and of my own free will. I UNDERSTAND THAT BY MY SIGNATURE I AM GIVING UP SUBSTANTIAL RIGHTS THAT I AM AGREEING NOT TO SUE JOHNSTON COMMUNITY COLLEGE OR ITS EMPLOYEES AND RELEASING JOHNSTON COMMUNITY COLLEGE FROM ALL LIABILITY. Signature: Title: Telephone: Agency: Range/Shoot House Date Usage: