Request edit access
PATH Outdoor Adventure Application
In order to be considered for an Outdoor Adventure with The PATH Foundation, please complete the required information below. After completing this form, follow the directions at the bottom to email or mail the medical documentation to complete this application process.
Applicant Name
Your answer
Street Address
Your answer
City, State, Zip
Your answer
Email Address
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Applicant Date of Birth
Your answer
Applicant Age
Your answer
Applicant Weight
Your answer
Applicant Height
Your answer
Clothing Information
Shirt Size
Coat Size
Your answer
Applicant will be accompanied by 1 person: I will be bringing the following person:
Your answer
Relationship of this person to applicant
Your answer
Please Check all of the below that apply to you
If you have fired a gun, what caliber and brand?
Your answer
Identify any hunting / fishing related experiences
Your answer
How did you hear about The Path Foundation?
Your answer
Describe your DREAM hunting or fishing "Outdoor Adventure"
Your answer
Identify any physical and/or mental limitations, as well as other medical concerns that might be a factor in this "Outdoor Adventure"
Your answer
Brief history of life-threatening or life-challenging condition:
Your answer
If selected to be a recipient of an "Outdoor Adventure", I would need the following special equipment: (wheel chair, gun rest, adaptive equipment, etc...) Please list all possible equipment
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms