Name(Required)
Address
Are you under the age of 18?(Required)
Do any of the following people in your life hunt? (select all that apply)(Required)
To what degree do you think your family, friends, and/or peers are supportive of hunting?(Required)
In your lifetime, how many times have you hunted?(Required)
What is your confidence level turkey hunting?(Required)
How many times have you turkey hunted?(Required)
How likely are you to go hunting within the next 12 months?(Required)
What is your primary reason for learning to hunt?(Required)

How did you find out about this program?(Required)

Liability and Photo Release Waiver(Required)
I, the parent/legal guardian of the participant desire to have my child participate in the Youth Pheasant Hunt Program and hereby consent to my child’s participation in the program and grant the club the unconditional right to use my child’s name, voice and photographic likeness in connection with articles, press releases and audio/video productions resulting from this event.

In giving my consent for my child to participate in the program, I understand that hunting is a sport involving firearms which, if mishandled can be dangerous and cause serious injury and/or death to my child or others. I understand and agree that my child will use utmost care during his/her participation in the program, and agree that he/she will adhere to the standards, guidelines and requirements of hunting and firearms safety. I understand and agree that my child will follow the safety instructions given to him/her by the club, its members, agents, employees, instructors and volunteers. I understand and agree that the club reserves the right to remove my child from the program if, in their opinion his/her safety or the safety of others is jeopardized. I understand and agree that I or another adult authorized by me shall be present with my child during all activities and events of the program.

In consideration for, and as an inducement to allowing my child to participate in the Youth Pheasant Hunt Program, and recognizing that my child’s participation in the program involves the use of firearms I, the parent/legal guardian intending to be legally bound, hereby, for my child, myself, my heirs, executors and administrators, voluntarily assume all risks of accident, injury or death and release and forever discharge the Commonwealth of Massachusetts, acting by and through the Division of Fisheries and Wildlife within the Department of Fish and Game and its officers, employees and agents (Commonwealth), the club and their officers, agents, employees, volunteers and assigns (collectively, the parties) of and from any and all claims, debts, demands, actions, causes of actions, suits, dues, sum and sums of money, accounts, reckonings, bonds, specialties, agreements, promises, doings, omissions, damages, executions and liabilities of whatsoever kind and nature, including but not limited to any and all liability for personal injury, death or property damage of any kind, both at law and in equity, and any that have been or may be claimed before any governmental agency, which have arisen or may arise as a result of or in association with my child’s participation in the program.

I hereby further covenant and agree that I shall save the parties harmless and shall indemnify the parties from and against any and all claims, liabilities and costs for any personal injury, death, property damage or other damages and loss that arise directly or indirectly out of or in connection with my child’s participation in the Massachusetts Young Adult Pheasant Hunt Program, including but not limited to the parties’ negligence, reckless or intentional conduct. I further agree that the club shall at no time be considered an agent or representative of the Commonwealth. This hold harmless and indemnity agreement shall include indemnity against all costs, expenses and liabilities incurred in connection with any such injury, death, loss or damage or in defense of any claim or claims on account thereof, including reasonable attorney’s fees.
Liability and Photo Release Waiver(Required)
If I am injured or suffer any illness or disease while residing at and/or participating in programs of MassWildlife, except as may be caused by the grossly negligent or reckless conduct of MassWildlife and their agents, employees, and volunteers, I agree to hold MassWildlife or their agents, employees, volunteers, or the host site harmless for said injury, illness, or disease.

In the event of an emergency, I hereby give permission to a physician to hospitalize, secure proper anesthesia, or to order injection or surgery, or other medical procedures required in an emergency situation.

I give consent for the Massachusetts Division of Fisheries and Wildlife (hereinafter MassWildlife), to provide medical attention, transportation and emergency medical services as warranted by the circumstances.

I am in good physical condition, and am not aware of any disease or injury that would be aggravated or result in my being incapacitated or injured during any program participation except as signed herein.

I further understand and agree to abide by the general rules of conduct prescribed for the guests of MassWildlife and violations may results in a denial of privileges, a forfeiture of all fees paid, and immediate removal from the hosting property.

I, agree that photographs or video taken of me during the event may be used in future materials describing and/or promoting the program or MassWildlife in print, website, or social media.
In the event of an emergency, I hereby give permission to a physician to hospitalize, secure proper anesthesia, or to order injection or surgery, or other medical procedures required in an emergency situation.
I give consent for the Massachusetts Division of Fisheries and Wildlife (hereinafter MassWildlife), to provide medical attention, transportation and emergency medical services as warranted by the circumstances.
I am in good physical condition, and am not aware of any disease or injury that would be aggravated or result in my being incapacitated or injured during any program participation except as signed herein.
I further understand and agree to abide by the general rules of conduct prescribed for the guests of MassWildlife and violations may results in a denial of privileges, a forfeiture of all fees paid, and immediate removal from the hosting property.
I, agree that photographs or video taken of me during the event may be used in future materials describing and/or promoting the program or MassWildlife in print, website, or social media.
By signing my name below, I attest I have read this release, understand it affects legal rights and responsibilities, and agree to the terms & conditions. I waive any claims arising while participating in the programs of MassWildlife
Please type your name here as acknowledgement of the liability and photo release waiver.