2 Shot Goose Hunt Application - Page 1

 

1st Team Member

Name __________________________________________

Age ___________ Occupation ______________________

Address ________________________________________

City, State, Zip ___________________________________

Home Phone _____________________________________

Work Phone ______________________________________

Fax ____________________________________________

Years Hunting Experience __________________________

Person to Contact in Case of Emergency

Name ___________________________________________

Work Phone ______________________________________

Home Phone _____________________________________

Relationship ______________________________________

 

2nd Team Member

Name __________________________________________

Age ___________ Occupation ______________________

Address ________________________________________

City, State, Zip ___________________________________

Home Phone _____________________________________

Work Phone ______________________________________

Fax ____________________________________________

Years Hunting Experience __________________________

Person to Contact in Case of Emergency

Name ___________________________________________

Work Phone ______________________________________

Home Phone _____________________________________

Relationship ______________________________________
For Office Use Only:
Date Received: ____________________________________ Notification of Receipt Mailed: ________________________
Hunt Committee Decision: ____________________________ Notification of Decision Mailed: _______________________
Entry Fee Deposit Date: _____________________________
Registration Information:
1st Team Member:
Survey __________ Duck Stamp __________ Migratory Bird __________ Conservation Stamp ____________
2nd Team Member:
Survey __________ Duck Stamp __________ Migratory Bird __________ Conservation Stamp ____________
 

 

 

 

2Shot Goose Hunt Application - Page 2

 
WHEREAS, the undersigned is a Participant, Team Member, Past Shooter or otherwise involved, in the GOSHEN COUNTY TWO SHOT GOOSE HUNT, known as and hereafter referred to as the "TWO SHOT GOOSE HUNT." The undersigned does agree to participate in said activities fully realizing the inherent danger in any type of sporting event of this nature and agrees to and assumes the risks inherent therein:

WHEREAS, the undersigned desires to release certain parties from any damages that may arise, directly or indirectly, as the result of his participating in the hunt known as the "TWO SHOT GOOSE HUNT."

NOW THEREFORE, in consideration of being allowed to participate in the GOSHEN COUNTY TWO SHOT GOOSE HUNT known as the "TWO SHOT GOOSE HUNT" the undersigned assumes all risks inherent in such an activity and does hereby release and forever discharge the "GOSHEN COUNTY TWO SHOT GOOSE HUNT," its officers, as officers of the hunt, and members, as members of the hunt, and individually: hosts, guides, judges, sponsors, huntsmen and all landowners upon whose land they may be hunting, from any and all manner of actions, causes of action, claims and demands whatsoever, in law or in equity, which may arise now or in the future as a result of, or pertaining to, the undersigned participation in said hunt or any of its activities.

AND, in consideration of being allowed to participate in the hunt known as the "GOSHEN COUNTY TWO SHOT GOOSE HUNT" the undersigned consents to allow pictures or likenesses of him/her to appear in any official documentary or exclusive coverage of the "TWO SHOT GOOSE HUNT" in any manner incidental to the undersigned participation and without compensation to the undersigned.

1st Team Member:

I, _________________________________________________ (signature)  being duly sworn, say that I am the person referred to in this record of application: that the statements herein contained are true to the best of my knowledge and belief and that I have read and understand the Release and Rules of the Hunt.

IN WITNESS THEREOF, I have hereunto affixed my hand this __________ day of ___________________ 20_____.

PARTICIPANT ________________________________________________________________

STATE OF ___________________________________________________________________

Now on this ____________ day of ___________________, 20_____ before me, a Notary Public, in and for said personally appeared to me known to be the identical person who signed the above release and acknowledge the execution thereof his/her voluntary act and deed.

Witness my hand and seal on the day and year above last written.

_____________________________________________________   My commission expires: ___________________
NOTARY PUBLIC SIGNATURE

 

2nd Team Member:

I, _________________________________________________ (signature) being duly sworn, say that I am the person referred to in this record of application: that the statements herein contained are true to the best of my knowledge and belief and that I have read and understand the Release and Rules of the Hunt.

IN WITNESS THEREOF, I have hereunto affixed my hand this __________ day of ___________________ 20_____.

PARTICIPANT ________________________________________________________________

STATE OF ___________________________________________________________________

Now on this ____________ day of ___________________,20_____ before me, a Notary Public, in and for said personally appeared to me known to be the identical person who signed the above release and acknowledge the execution thereof his/her voluntary act and deed.

Witness my hand and seal on the day and year above last written.

_____________________________________________________   My commission expires: ___________________
NOTARY PUBLIC SIGNATURE

 

 

The Artist Challenge Entry Form is available in Adobe PDF format. If you have free Adobe Acrobat Reader software installed, you can download the  2 Shot Past Shooter Entry Form  Application.pdf  for page one of the application and Applicationp2.pdf for page two .

Click on this button to get Adobe Acrobat Reader:  Adobe Reader - Download

This completed, signed and notarized (by both team members) application must be submitted to participate as a hunter in the 2 Shot Goose Hunt. An entry fee of $400 is required. Certified checks, money orders, and personal checks post dated for May 1 of the current year are accepted. Application deadline is May 1.

Print the information above and mail your signed and notarized application along with entry fee to:

2 Shot Goose Hunt
Hunt Committee
P.O. Box 246
Torrington, WY 82240

Notification of Hunt Committee decision will be mailed to "1st Team Member" by May 15.

If you require further information or would like an application mailed to you, write to: 2 Shot Goose Hunt, P.O. Box 246, Torrington, Wyoming, 82240 or contact committee representatives: Ron Miller 307-532-3613; Cactus Covello at 307-532-2141; or Tom Feeser at 307-532-1638. You may also submit the form below for additional information.or send e-mail to: info@2shotgoose.com.

 

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