JAKES DAY Registration
When: August 10, 2019 (rain or shine) 8:30 AM to 4:00 PM
Where: Greensburg Sportsmen's Association Club Grounds on Freeman Road (Near Westmoreland County Fairgrounds)
Due Date: July 28, 2018
Cost: $15 per child and is non-refundable
Make checks payable to: N.W.T.F. PA Local #1 ****PLEASE DO NOT SEND CASH IN THE MAIL****
REGISTRATION IS LIMITED
Registration begins at 7:30 AM
AGENDA: (includes the following and is subject to change)-Trap shoot, Still Shoot, Archery,
Cherokee Run, .22 Rifle, Fishing

This is a day long event with a lot of walking involved (up and down hills). Please have child(ren) wear comfortable clothes and shoes and sunblock. Parents are welcome to attend the event with their child(ren). Lunch will be provided and each child will receive a t-shirt.

Please mail all checks to:
Sherry Samulski
Secretary NWTF PA Local #1
1249 Greensburg Pike
West Newton, PA 15089

Questions regarding the event can be emailed to ssamulski8517@gmail.com or you can call Sherry at 724-331-8632 and leave a message.

Email address *
Child's Name *
Your answer
Child's Age by 8/1/19 *
Your answer
Shirt Size (adult sizes) *
Street Address *
Your answer
City *
Your answer
Zip *
Your answer
Phone number for contact prior to event *
Your answer
Parent or Legal Guaradian attending? *
Number of Parents or Legal Guardians attending *
Your answer
Name of Parents or Legal Guardians attending *
Your answer
Phone Number in case of emergency during event (if same as above, leave blank)
Your answer
Does the child have allergies/medical conditions? *
If yes, please list below
Your answer
Is the parent or legal guardian willing to be a group leader? *
Has the child attended JAKES Day before? *
Will the child be attending any other youth field day events this year? *
If possible, please put my child in the same group as:
Your answer
Release of Liability and Photo Release
As parent or legal guardian of the child listed above, I certify that said child has my permission to attend and participate in all activities on August 10, 2019 at the Greensburg Sportsmen's Association, Freeman Road, sponsored by the PA Local #1 of the National Wild Turkey Federation. By selecting yes below, I hereby waive and release all other participants, the host, sponsors and all other officials or parties involved in the event from all claims and/or damage incurred in connection with this event. I also hereby grant the sponsor and co-sponsors the unconditional right to use the name, voice and photographic likeness of the above said child, in connection with any of the articles, press releases and audio/video productions.
*
Form of Payment *
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