Youth Hunting Application

Applicant Information

Full Name (required)

Address (required)

Date of Birth (required)

Gender

Is the youth on any medications?
YesNo

If yes, please describe:

Please describe any allergies, handicaps, or other medical conditions:

Does the youth have any previous experience in hunting?
YesNo

If yes, please describe:

Does the youth have any previous experience harvesting game?
YesNo

If yes, please describe:

Parent/Guardian Information (must be 18 years or older)

Full Name (required)

Address (required)

Date of Birth (required)

Gender

Daytime Phone

Evening Phone

Mobile Phone

Relation to Applicant

Hunting Experience

Hunter Safety Information

Name on Certificate

Date Completed

Certificate/License Number

Have you ever been convicted of a felony?
YesNo

Emergency Contact

Full Name (required)

Address (required)

Phone

Relation to Applicant

Reservation Information

Class*
Beginner - Youths aged 10-16 years with no previous hunting experience.Intermediate - Youths aged 10-16 with limited hunting experience; familiar with the basics.Experienced - Youths aged 10-16 years with extensive hunting experience.

* Please note that the Old meadow Hunt Master will have the right to determine which final category the youth will hunt in. He or she may also terminate any hunt due to unsafe or unethical behavior, or failure to follow directions.

Desired Start Date

Desired End Date

What kind(s) of hunting is the youth interested in?
RifleShotgun

What kind of game is the youth interested in?
MooseDeerBearTurkeyGrouseRabbit

The following forms must be submitted with this application:

Parental consent form
Current hunting license and/or certificates

Please fax or mail copies of the above so that we may confirm your eligibility for Old Meadow Camp. By submitting this form, you acknowledge that Dean Young Forestry is not liable for any accidents or injuries that occur during your stay at Old Meadow Camp.

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