Outdoors Application

Please fill out both of the forms on this page. We will need an application in order to submit your name into the lottery system.

Submit an Application for an outdoors event

DATE YOU ARE SUBMITTING APPLICATION *

EVENT NAME *

PROVIDE THE NAME OF THE EVENT YOU WISH TO ATTEND

NAME *

EMAIL *

ADDRESS *

Apt, suite, etc.

Country

City

State

Zip code

PHONE *

AGE *

WEIGHT *

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT PHONE *

DISABILITIES *

DESCRIBE DISABILITIES *

PLEASE DESCRIBE ANY DISABILITIES THAT WILL EFFECT YOUR ABILITIES OUTDOORS

MEDICATIONS *

PLEASE ANY MEDICATIONS YOU ARE TAKING IF NONE WRITE NONE

Date OF LAST MEDICAL CHECK UP *

NAME OF MEDICAL PROVIDER *

ALLERGIES *

LIST ANY ALLERGIES

LAST TIME YOU WERE FISHING OR HUNTING *

PLEASE PROVIDE A ROUGH TIME FRAME OF WHEN YOU WERE LAST OUTDOORS

LAST TIME YOU FIRED A WEAPON *

WHEN WAS THE LAST TIME YOU SHOT A GUN?

DO YOU HAVE YOUR OWN WEAPON/FISHING POLE? *

IF YES YOU HAVE YOUR OWN WEAPON, WHAT DO YOU HAVE? *

IF YOU HAVE A FISHING POLE IS WHICH IS IT? *

BRANCH OF SERVICE *

RANK *

TIME OF SERVICE *

HOW MANY YEARS OF SERVICE *

DO YOU HAVE YOUR OWN TRANSPORTATION TO THE EVENT? *