11th ANNUAL UNION COUNTY PHEASANTS FOREVER CHAPTER 535 YOUTH & LADIES SHOOT 10/13/2012 and YOUTH

HUNT 10/20/12
Its time once again for the Youth & Ladies Shoot and Youth Hunt! Enclosed you will find all of the information that is necessary in order to participate in this years Youth & Ladies Shoot and Youth Hunt. In order to participate in the Youth & Ladies Shoot all forms must be completely filled out and handed in at the event. If you are participating in the Youth Hunt ONLY all forms MUST be completely filled out and returned to the address below no later than October 13th, 2012 for the Hunt. This allows sufficient time to line up enough dog handlers and make arrangements with property owners. These forms are required in order to participate in one or both events. The Youth & Ladies Shoot will be held at the Ross Farm located behind the Richwood Fairgrounds and will start at 9:00 a.m. on October 13th, 2012. You can also bring your forms at that time. The Youth Hunt will be held on October 20th 2012 with the morning Group arriving at 8:00am and hunt begins at 9:00am, the afternoon arrival at 11:30am with hunt starting at 12:30pm. Please indicate below if you prefer a morning or afternoon hunt. If your request cannot be honored you will be contacted in advance. Participating Youth must be ages 10 17 . All Youth need to hold a valid hunting license, are required to wear hunter orange, and must be accompanied by an adult. All hunters and dog handlers will leave for their respective hunt destination from Bokes Creek Hunting Preserve 24330 Sandusky Rd., Richwood, just north of St. Rt. 347 between St. Rt. 4 and St. Rt 31. Please send forms to: Larry Wright, 15390 Smart Cole Road, Ostrander, OH 43061 Questions?
JOE WILEY (PRESIDENT) (740)-225-4655 TOM ROSS @ TOM ROSS AUTOMOTIVE (740)-943-2096 SCOTT JEREW @ KALE MARKETING (740)-255-7794

-----------------------------------Cut here and mail to address above---------------------------Name_________________________________ Date of Birth__________ Address___________________________________________________ Parent/Guardian_____________________________________________ Phone Number/email address__________________________________________ Preferred Hunt Time_____ A.M._____P.M.

UNION COUNTY PHEASANTS FOREVER CHAPTER 535 YOUTH AND LADIES SHOOT 10/13/12 & YOUTH MENTOR HUNT 10/20/10 WAIVER
I understand that shooting sporting clays and hunting is a sport involving firearms. Firearms, when mishandled, can be dangerous. Further, I understand that it is incumbent upon me to use the utmost care in the exercise of firearm safety. I intend to do so and realize that I have an affirmative duty to do so. I further realize that Pheasants Forever, their members, agent, employees, licensees, volunteers, and associates are participating in this shoot/ hunt to give me a quality outdoor experience. This participation by the referenced individuals will include travel to certain hunting areas. It also includes hunting with dogs. I understand that I will conduct myself in a manner so as to be safe around all of the individuals mentioned herein and their dogs. Further, I hereby waive all right to any claim, cause of action, right of litigation of any kind, whatsoever, originating from 10/13/10 through 10/20/12 Chapter 535 Youth Shoot /Youth Hunt and therefore for all times as to the Union County Pheasants Forever Chapter 535, members, employees, volunteers, licensees of said organizations and their agents. I realize it is a privilege to participate in the Union County Pheasants Forever Chapter 535 Youth Shoot / Youth Hunt and accordingly I will conduct myself in a safe manner consistent with all affirmative duties which I have heretofore recognized. __________________________________________________ Participants Name _______________ Date of Birth

_______________________________________________________________________ Participants Address ______________________________________________________ ________________ Participants Signature Date

______________________________________________________ ________________ Signature of Parent/Guardian of Participant Date