LTH Hunter Registration Form 2020
Please answer all questions before you submit this form. All information below is confidential and will only be shared with the Pulaski LTH Coordinators. YOU WILL NEED a DNR customer number for your child to complete this form. Visit https://dnr.wi.gov/goWild/customerNumber.html to get this number for your child (preferred) or call WI DNR at 1-888-936-7463 from 7am-10pm. There is no cost to get a DNR customer number. Please remember that your registration does not guarantee a spot in our program; we will do our best to match hunters with mentors. Thank you for you interest in the Pulaski LTH turkey hunt!
Hunter's First Name *
Hunter's Last Name *
Street address *
City *
State *
Zip Code *
Birthdate *
mm/dd/yyyy
Age *
What is hunter's DNR customer ID number? *
Visit https://dnr.wi.gov/goWild/customerNumber.html to get this number for your child. Or call WI DNR at 1-888-936-7463 from 7am-10pm
What is hunter's cell number?
If applies (xxx-xxx-xxxx)
Can this phone receive texts for last minute information?
Hunter's email address
Parent/Guardian's email address *
Parent/Guardian's first name *
Parent /Guardian's last name *
Parent/Guardian's home phone *
(xxx-xxx-xxxx)
Parent/Guardian's cell phone *
(xxx-xxx-xxxx)
Can parent/guardian's cell phone receive texts for last minute information? *
Required
Parent/Guardians: another emergency contact and phone number *
(xxx-xxx-xxxx)
Who will accompany the child on the hunt? *
If a mentor of the same gender as the hunter is not possible, a family member/guardian is required to accompany the hunter in the blind during the hunt.
Required
If a family friend or guardian is accompanying the hunter on the hunt please provide full name of this person.
Cell number of friend or guardian
If applies (xxx-xxx-xxxx)
Has an active Pulaski LTH mentor agreed to take your child in the field? *
If yes, please give name. New mentors are no longer able to mentor their own child unless they are part of the mentor trainee program.
If "yes" to previous question, what is the Pulaski LTH Mentor's name?
How much experience with firearm handling and shooting does your child have? *
Required
How much experience with does your child have hunting upland birds and waterfowl? *
Required
What gear does your child need to participate in the hunt? *
Check Items your child will need.
Required
The MANDATORY Classroom/Range Instruction day will be held at the Pittsfield Trap Club 3142 Brookside Dr. Pulaski. Would you prefer to: *
We will do our best to honor your preference. We ask that you support the Pittsfield Trap Club by eating lunch there, as they graciously aid our program by hosting this day free of charge. They normally grill hamburgers, brats and hotdogs and have chips, soda, and bottled water for purchase.
Required
Saturday morning, March 28th is your LTH Hunter available to hunt? *
(AM is considered from dawn to around 10 AM)
Saturday afternoon, March 28th is your LTH Hunter available to hunt? *
(PM is considered 2 PM until dusk)
Sunday morning, March 29th is your LTH Hunter available to hunt? *
(AM is considered from dawn to around 10 AM)
Sunday afternoon, March 29th is your LTH Hunter available to hunt? *
(PM is considered 2 PM until dusk)
Saturday morning, April 4th is your LTH Hunter available to hunt? *
(AM is considered from dawn to around 10 AM)
Saturday afternoon, April 4th is your LTH Hunter available to hunt? *
(PM is considered 2 PM until dusk)
Sunday morning, April 5th is your LTH Hunter available to hunt? *
(AM is considered from dawn to around 10 AM)
Sunday afternoon, April 5th is your LTH Hunter available to hunt? *
(PM is considered 2 PM until dusk)
My family plans on attending the Landowner/Mentor/Parent Appreciation Dinner on Monday April 6th from 5:30 PM - 7 PM at the Pulaski High School Commons *
(This event is STRONGLY recommended to say thank you to all who provided this for you)
We plan on bringing a family sized dish to pass to Landowner/Mentor/Parent Appreciation Dinner on Mon. April 6th . I will most likely bring.... *
We need a general idea of what we will have, we understand that this may change before April 6th.
Has your child completed Hunters Education? *
(This is NOT mandatory but helps us plan our range day)
Required
Does your child have any health concerns that would affect their participation in the learn to hunt program? *
Health concerns do not preclude a child from participating. Physically challenged youth are encouraged to participate. If you have concerns not listed below that may challenge your hunter, please contact one of our coordinators for additional information.
Required
Family doctor's name or clinic *
Family doctor's phone *
(xxx-xxx-xxxx)
Hospital preference *
(The nearest hospital will be used in an emergency)
If a parent can not be reached, I hereby authorize the mentor attending to my child on the hunt to secure immediate medical attention or hospitalization for my child, in the event of a medical emergency. *
Required
I understand there is a $20 fee to participate in this program. Checks should be made out to the “Pulaski Area Learn to Hunt Program" and mailed to: Pulaski Area Learn to Hunt Program Attn: Terry Erdmann LTH Director 7311 Lower Road Sobieski, WI 54171 *
Required
I understand Pulaski Learn To Hunt does not provide medical insurance for my child for the purpose of this hunt, and I am solely responsible for providing such insurance and for payment of any medical expenses for my child that are not covered by my insurance. I have read this information, verified its accuracy, and agree to the statement made above. Your name below is an electronic signature and by entering it here you agree to all statements above. *
I give my permission for my child's picture, voice and likeness to be used in Learn to Hunt press releases, social media, and webpage. (NO names will be added.) *
Required
I give my son/daughter permission to take part in the learn to hunt program sponsored by the Pulaski Area Learn to Hunt Program and the Wisconsin DNR. All participants take full responsibility and waive all liability from the following organizations; Pulaski Area Turkey Chasers of the NWTF, the Pulaski FFA, Pulaski Schools, WI DNR, Pittsfield Trap Club and all participating members, their equipment used, landowners and the properties of. This includes a day of instruction of turkey hunting, gun safety and handling, and accompanying days of instruction and LTH hunting dates. I understand that there are inherent risks associated with such an event, since my child will be walking in the dark, possibly on uneven terrain, handling a loaded firearm and possibly driving with mentors to hunting areas. I also understand that while hunting, young hunters will have a mentor within arms reach at all times, as required by state regulations. As a parent, I also understand that my child is the only one with a loaded firearm, and gun safety will be made a top priority. *
Required
Is there any other information that you can share that will help us give your child a once in a lifetime learn to hunt experience?
Submit
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