2011 LPWA Youth Hunt Application

singlemalt

Well-Known Member
LONG POINT WATERFOWLERS ASSOCIATION
YOUTH WATERFOWL HUNTING DAY
REGISTRATION AND APPLICATION
Sat. October 1st, 2011

1. YOUTH HUNTER APPLICATION: 12-16 Years of Age.

Name of Youth Hunter: _______________________________________________.

Birth Date dd/mm/yyyy_______________________________________________.

Address: ___________________________________________________________.

Town/City ______________________________ Postal Code: _________________

Telephone: ___________________________. Email: __________________________

Date of Birth: _________________ Hunter Apprenticeship Certificate #:____________*

Or Small Game License #_____________________*. Date of Issuance: ____________.

Signature: ___________________________________. Date: _____________________.

* License information is required. If you do not have it yet you have until Aug. 1st to provide or your application will be rejected.

2. MENTOR INFORMATION:

Each youth must be accompanied by a parent or their designated guardian.

Name of Mentor: ______________________________________________________

Address: ______________________________________________________________

Town/City: ________________________________. Postal Code: _______________.

Telephone: _______________________. E-mail: _____________________________.

Date of Birth: _____________________. Outdoors Card #: ______________________*.

Number of years Experience Hunting Waterfowl: ____________________________.

* The day of the event the mentor will be required to provide a valid Ontario Small Game License and Federal Migratory Bird Permit.







3. EQUIPMENT:
In order to help us make your hunt a successful and enjoyable day please let us know what equipment you have and special requirements you may need. It is required that you bring your own shotgun and please remember the Ontario Law requires youth and mentor must share only one firearm. Shotgun Model and Gauge: ________________________.

• Is the Youth Hunter Disabled in any way? LPWA can make special provisions for wheelchair access etc. Please provide as much detail as possible: ________________________________________.


• Will you provide your own boat? Yes/No. Boat Type___________.
Length: ______________. Motor Size: ____________________.

• Do you have waders? Yes/No. Hip or Chest? ___________________.

• Do you have your own Decoys? Yes/No. How many________________.

• Do you have a trained retrieving dog? Yes/No

• Would you like an experienced waterfowler from the LPWA to accompany you? Yes/No



IMPORTANT! There is no cost to the youth for this event however a $15.00 Application Fee is required to hold your position for the Youth Hunt. This will be refunded the day of the event. Cheques should be made payable to The Long Point Waterfowlers Association and accompany this application.


*Please note we expect this event to be fully booked so to ensure fair and orderly allocation of spots applications will be accepted only via Canada Post to the following address, no hand deliveries will be accepted!

Cameron Thomson
Long Point Waterfowlers’ Association
207 Brant School Road, RR#1
Brantford, ON
N3T 5L4

519-758-5024
 
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