Welcome to Challenge the Outdoors, Inc. September 2017 NEWSLETTER

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1 1 President s Message Carl Gierke: Welcome to Challenge the Outdoors, Inc. September 2017 NEWSLETTER There are a lot of things to talk about since our last newsletter some good and some not so good. First, the sad news. As most of you know, our good friend Peter Lathrop passed away unexpectedly on August 8 th at his home. Peter exemplified what CTO was all about. His willingness to help out and participate in CTO events, and always do it with a smile, was truly inspirational. Thankfully, Peter got to see a lot of family and friends in his last few weeks. He attended the CTO Annual Meeting on July 22 nd and proudly presented the Volunteer of the Year Award to his father, Bob. Congratulations to Bob on your award and a big THANK YOU for all you ve done for CTO over the years. By the way, the next time you see Bob, wish him Happy Birthday (he turned 90 on August 23 rd ). Peter also got to attend his dad s surprise birthday party on July 29 th along with a lot of family and friends, and also attended the CTO Timber Rattlers game (which he organized) on August 6 th. Keith Pamperin has included a tribute to Peter in this newsletter outlining his many accomplishments. We ll miss you Pete! On a happier note - At our Annual Meeting, new directors were elected to fill vacant spots. Brian Hess, Chuck Duffeck, and Ivan Craig decided not to continue on the board and we thank them for their many years of service. Newly-elected directors include Gary Vanden Heuvel, Fred Kaun, and Doug Thiele who officially began their terms as of the August Board of Directors meeting. Doug was also elected Treasurer. We thank them, and all the directors and event coordinators, for offering their time and expertise to CTO and look forward to working together. On August 26 th, CTO partnered with DaVita (one of our Sponsor Members) to take some of their disabled patients on a fishing trip on Shawano Lake. DaVita is based out of Green Bay and performs dialysis services. In spite of the fact that a nice day was forecast, it started raining in the morning and turnout was less than anticipated. However, the people that did show up had a good time and even caught a few fish. Thanks to Randy Hartleben and Mike Schulze for providing their pontoon boats and expert guide services and to Bill Mayille and Tammy Kritz for helping with the event too. Sherrie Diemel helped organize the event for DaVita and we thank her for her help also. Hopefully, we can do it again next year when the weather is a little nicer. There are a lot of events coming up, so get out there and enjoy the outdoors and take advantage of the events CTO offers. If you d like, bring along a friend or two who might be interested in CTO we re always happy to see new faces. Hope to see you at an event this fall. Tribute to Peter Lathrop- Keith Pamperin Peter Lathrop was a friend of Challenge the Outdoors. Peter, although small in stature was really big in heart! Peter greeted everyone with a smile and had the ability to listen and understand the struggles we all face in life. Although Peter faced difficult personal health challenges, he persisted with creativity, courage and determination. He always made time to consider the struggles that others face. Peter understood that everyone may be less than perfect, but still deserving of compassion and kindness. He motivated us to be kind, generous and considerate of others. Peter was a diligent member, officer and friend of Challenge the Outdoors. He served as Secretary for many years, always keeping the records of meetings and written correspondence. As an officer, he was an active member of the Executive Committee, chaired the Awards Committee and Scholarship Committee and chaired the Timber Rattler and Green Bay Blizzard Events. Peter was an avid fisherman, Green Bay Packer Fan and loved his baseball, especially the Brewers and Timber Rattlers. He was famous for his March Madness Pete's Picks College Basketball Pool. Peter's hearty love of life inspired family, friends and competitors. Rest in Peace my friend. How to Place Events On The CTO Calendar If anyone has an event that isn't on CTOs calendar or needs updated information, please Cliff at deb57ncliff55@gmail.com with that information and I will update the calendar. Please visit to view CTOs calendar.

2 2 October Special Disabled Deer Hunt Pat Nieuwenhuis: We will be having a Pre-Hunt meeting again this year, similar to the past couple years. The meeting will be on Saturday Oct.7, 2017 at 10:00 am. This is the first day of the hunt. Lunch will be served and we will get you out for the afternoon/evening hunt. This year s hunt will once again be headquartered at the Lessor Town Hall in Landstad. To reach the Town Hall from the South, take Hwy 47 out of Black Creek for about 13 miles until you reach Landstad Rd (Ye Old Plow Shop) and turn right or to the east. If coming from the North, take Hwy 47 and head South from Bonduel about 5 miles to Landstad Rd and turn left. The Town Hall is less than a quarter mile and will be on the right side of the road. Volunteers are also always welcomed and needed to assist with the actual hunt. We have had great helpers in the past. Remember we can t pull this off without you. Please call Pat Nieuwenhuis at if you can help. List of Upcoming Board of Director Meetings All meetings 6PM. Here is the list of upcoming meetings and locations. September 19-Options for Independent Living at 555 Country Club Road, Green Bay October 17, November 14, Dec 19 -American Legion at 3220 West College Avenue, Appleton New Members Please welcome Dave & Holly Adamovich, David Schieble and Ken Sellenheim. FALL PHEASANT HUNT- Adamovich: The hunt will take place Sunday, October 22 starting at 8 AM at J&H Game Farm, W5810 J&H Road, just West of Navarino off of HWY 156. We will be coordinating the stocking of birds, dogs and handlers, machine operators, back-up shooters, cleaners and baggers, great food and just a great day to get to know other CTO members and listening to the stories. Each disabled hunter will be allowed two pheasants. If you have a favorite recipe and would like to share, bring it with you. If you don t have your own gun, there will be guns available at J & H Game Farm for you to use. Shotgun shells, (12 gauge and 20 gauge), have been donated by John Kempen- Thanks John! You need to wear orange. Each hunter is welcome to bring family members or a friend to assist them, but pheasants are put out only for the disabled CTO members. Food is being made by J & H, which is always delicious. Don t forget to sign up by October 19, 2017 if you are going to be part of this hunt. If you have any questions, please contact Adamovich jimrita0208@yahoo.com or CTO End of Summer Outing at Outagamie Conservation Club Rita Adamovich: The event is scheduled for Saturday, September 16th and will start at 10 AM. No end time is set because the very accommodating folks at OCC are very willing to be flexible in the planning of our event schedule. We will have trap shooting with CTO picking up the cost of a round or two for those taking part. If you do not have a shotgun, OCC has a few that will be available to borrow. You are welcome to bring your own shells or you can purchase 12 or 20 gauge shells there for $7 a box. CTO will pick-up the cost of one box of shells purchased at OCC for use at the outing, and/ or we may have our own shells to give out. We hope some of our members who have wanted to try trap shooting take advantage of this great opportunity. If you would like to show-off some of your adaptive shooting equipment and /or give instructions to a new shooter, that would be awesome. Please contact Rita to let her know you are available to help out. The pistol range will also be available to anyone interested and you are responsible for bringing your own pistol and ammunition. Targets will be supplied. Archery shooting will be available and OCC has a crossbow or two to loan out and we will have at least one of our crossbows available as well. There will be fishing at the stocked pond that will be catch and release only, unless the fish is deep hooked and won t survive. Bring your favorite rod and tackle. We will provide live bait and you may bring your own as well. We hope to have a fly fisher or two to demonstrate fly fishing for anyone interested in learning a new skill. The pond is stocked with trout, panfish and largemouth bass. The terrain is very flat around the pond and the entire OCC grounds, so getting around will be fairly easy, but you may want to bring a power scooter as the activities are spread out. CTO will be making the main meat dish and I m sure it will be great whatever our cooks decide. All those attending are asked to please bring a dish to pass! There is a nice clubhouse for serving the meal in and an open bar to purchase beverages. CTO will be providing water only. We will have some cards available for anyone interested. This is a rain or shine event and is

3 open to all our members and we hope you and your family can make it a great day at OCC. Come out and participate in any of the activities you wish to, or just come out and enjoy in the social interaction. OCC is a great place to enjoy the many different activities and it gives our members a chance to learn a new skill. Hopefully, this opens more of our great outdoors to all who are willing to try something new and exciting and see what the OCC has to offer throughout the year. You can check out their website to see what s going on at: We thank the many fine people at OCC for helping make this event a reality. We ask that you register by please calling or ing Rita Adamovich at: (920) or at: jimrita0208@yahoo.com or call our office at: (920) or at: CTOforMe@yahoo.com Thank You! Map and Directions to Outagamie Conservation Club; You can choose any of the directions/routes that suit you - these are just suggestions. Address: Outagamie Conservation Club, N3502 Mayflower Rd, Hortonville, WI Phone: (920) From the South or West-Take Hwy 15 to Mayflower Road (approximately 1.5 miles west of HWY 41 and 2 miles east of Greenville) to Mayflower Road, go North on Mayflower Road approximately 5.5 miles to entrance on right hand side. From the North or East take Hwy 47 south approximately 7 miles south of Black Creek and 1.5 miles north of Mackville to Wege Road, go West on Wege Road approximately 4 miles to Mayflower Road, turn right (North) and go approximately 3/4 of a mile to entrance on right hand side. CTO ANNUAL SHOOT TILL YOU DROP Adamovich: Come join us for our annual fall Shoot till You Drop on Tuesday, September 19 th from 8 until 4. J&H Game Farm will be hosting the event and they are located at W5810 J&H Road, just West of Navarino off of HWY 156. CTO picks up the cost of the clay birds and the ammunition for this daylong event. Volunteers that help the disabled shooters will be able to also shoot as much as they want. You can choose from the traditional sporting clays course, wobble flurry, skeet, and 5- stand events. Food will be made by J & H. Pre-sign up is encouraged, but I want to remind everyone that it is your responsibility to sign in at the shoot, as well for each round and type of shooting you do and the amount of shells you use. Please put this on your calendar. Don t forget to sign up by September 16, 2017 by ing Adamovich at jimrita0208@yahoo.com or call at Hope to see you there. 3 Youth and Lady Day September 9 th J&H will be hosting its Annual Youth & Lady Day of Outdoor Instruction on Saturday, September 9 th. Registration will be from 9AM 3PM and activities will run until 4PM. This is a free event for all ladies and all kids up to age 18. Activities will include shotgun, 22 and BB gun shooting stations, archery, fly casting, and the trout fishing will again be sponsored by Challenge the Outdoors. There will be displays by the DNR, Al Meier s Taxidermy and the Rocky Mountain Elk Foundation Ladies Group. Food is also furnished along with a door prize for each participant. For more information about the activities, or if you wish to make any donations, please contact Diane at J&H at or her at jhclub@tds.net Attn. CTO members: CTO is always looking for helpers at the Trout Pond. If you would like to help the youth and ladies catch the fish or join those who clean the trout after they are caught, please contact Carl Gierke at or cgierke1@outlook.com Wheel Chair Wash- Friday, September 22: Keith Pamperin The Knights of Columbus, Council 617 and Options for Independent Living Inc. are hosting a Free " Wheel Chair Wash, Friday September 22nd from 9am to noon at Options for Independent Living Inc., 555 Country Club Road, Green Bay. (East End of NWTC Parking lot) Bring your wheel chairs, power chairs and scooters for a hand washing. Tour the Options for Independent Living Accessible Home and discuss the services provided through Options. Any questions call Keith Pamperin, Wheel Chair Wash Chair, CTO Water Fowl Hunt: Keith Pamperin CTO is considering a Fall Waterfowl Hunt. We would like to determine how much interest there might be in participating in an early Goose Hunt or a later Duck Hunt if CTO secured a time and place for members to hunt. Please or call

4 4 Keith Pamperin, at or call if you would be interested. The level of interest will determine if we work to put a waterfowl hunt together. Wheel Chair Pheasant Hunt: Jerry Schick On Sunday November 4 th, Pheasant Crest located in Oxford, WI will host a pheasant hunt for physically- challenged individuals using wheel chairs. The hunt is 100% sponsored and consists of shooting trap from an action track chair to get warmed up. You will be taken to the field with a guide and a pointer to hunt for a total of four birds. A back-up shooter will be available if needed and requested. Lunch will be provided and a promise of a good time listening to and telling all the great stories of this and other hunts. There are openings for sixteen to twenty-four hunters. To apply, please contact Wayne or Robin Smith at New Opportunities for Fishing/Sight-Seeing: Mark Baehr Don't pack your fishing gear away yet, the fishing is going to get better real soon! At least that's usually what happens as the fish really start to pack on the calories (your bait hopefully included) as we transition from summer to fall and yes eventually winter, hopefully sometime in late January. Hey, we can dream can't we?! It's also one of the prettiest times of the year with those amazing fall colors all around painting the landscape with every color imaginable. Another great reason to love living in a true four- season state! And with a little luck and planning we hope to get out on the water to partake in this awesome season to enjoy the many amazing sights and sounds and harvest some of nature s yummy bounty provided for us in the form of those feisty, fun to catch, and delicious to eat fish. Sounds like a winner to me, Sign me up! How about you? Here's the short version of how we hope to do our part in making this happen. We assigned a couple of people to make contacts and check out some locations we think are of reasonable distance of many and have a good to better than average fishing catching chance with some great vistas to boot. We ended up with a few fitting the bill; the Wolf River (near Fremont and Winneconne) and on the Waupaca Chain O Lakes (in King). There are businesses that rent pontoon boats near each location, are semi-wheelchair friendly (they have max width gates of 30 ), have suitable loading docks, and little to no stationary seating (most have moveable chairs provided making fishing a bit easier). Parking is not perfect but doable and some have bait and other amenities as well. We can reserve the boats for weekdays and or weekends depending on interest, and we can get a great rate for weekday rentals on the Waupaca Chain when reserving for three or more consecutive days. They also have a few pontoon boats available that will suit our needs. We are looking at late September thru mid-october for our window of opportunity to get out. Members would be looking at half-days (3 to 4 hours) on the water with either morning or afternoon trips, with the possibility of a whole day depending on how many people show interest. Our disabled members will be given priority and we will fill in with ablebodied individuals where space provides. If there is an overwhelming response, we will come up with a fair system to address the situation. How many separate trips will we be taking? Good question! There will obviously be a limited number of trips, but some factors include; member interest, volunteer participation, and availability of boats, and of course weather. We will make the best call possible given the information we have when setting a date(s) and location(s). Safety 1st! and doing our best to make sure the trips are enjoyable and not over crowded are priorities. The Chain O Lakes is definitely easier boating (more sheltered), but fishing may be more challenging with extremely clear water, but very nice views. The Wolf River and up-river chain is more productive in fall, but traveling can be more difficult due to high wind, so sticking to sheltered areas would be wise. The Wolf River also has very nice viewing. River fishing also calls for different gear/tackle, namely river-rigs to fish the current, but backwaters offer panfish and pike with bobbers or casting. A lot of options depending on what's hitting any given day or what you want to try for. We'll do our best to get up to date fishing reports so we'll be prepared.

5 Now it's your turn! To show your interest in either wanting to be a volunteer or angler/sight-seer please contact Doug Thiele at: (920) or Mark Baehr at: (920) by September 18, If you do not contact them by then, it doesn't mean you won't be able to go, but we will start on picking a date(s), making reservation(s) and picking a location(s). If there is space still available, you will be welcomed aboard. If you have questions/concerns, please ask and we will do our best to address them. THANK YOU! The Challenger is going to be on the move! Mark Baehr We are also planning on bringing the "Challenger" from Cecil to Omro in mid-september where Doug Thiele and his son have volunteered to give it a good thorough inspection, make necessary repairs/improvements, and make recommendations as to its future. I wonder, how many of you knew "Challenger" is the official name of our pontoon boat? After inspection and any necessary fixes are performed, we would like to get it out on the water near Omro this Fall to provide more fishing opportunities. This would really be a great situation if we can make it happen, we ll try! If this were to happen it would likely be late September or early October. FISH ON!! Gotta go! HIGHLIGHTS OF RECENT BOARD MEETING- Judy Paluch JUNE 1.The 2017 budget was voted in. There were a few new changes in the budget, and there were no questions about it. The executive committee adjusted for the events that have increased in size. 2.We need a new volunteer list. Pat said that some people just want to volunteer for certain types of events, and we need more volunteers to update our list. We should put that request in the newsletter, and have anyone interested in volunteering send us their name, address, phone number, and what type of events they are interested in volunteering for. Right now our address isn t working, so call our office at and leave a message, your name, and phone number; we will pass on the information. Or write a letter to our office. 3.A member of Challenge The Outdoors may be a committee organizer for our events. Those interested in running one of our events may get in touch with us. Our phone number for the office is We put pictures on the website about our events. If anyone has pictures from our events, that they would like to be included on our website, send them by to palj22@att.net. They will be put with our other pictures. Please include your name and address. Or you can send the pictures to our office; the address is at the top of the page. JULY 1.The Pontoon boat has been fixed and we should not have any more problems. We have found that people get caught in the weeds, and they should not try to plow through them; this damages the motor. Back up and go around the piles of weeds. Weeds caught on the motor need to be pulled off if too thick. The best is to check with the person that helps you get the boat set up, and have him tell you where the weeds are, and try to avoid them. 2.It was suggested that we get an audio system and a wireless microphone to make it easier for the people to hear us better at our events. 3.We are moving our meeting dates for the Board of Directors to the American Legion in Appleton (3220 West College Ave) as of October. We meet on the third Tuesday each month at 6:00 p.m. All members are welcome. 4.Our membership list is being updated. If any member has moved or changed their phone number or changed to a cell phone, we would appreciate if you would let us know. Our phone number is or mail the change to our office. Our information won t reach you if your information is incorrect. We are having trouble with the membership applications not being filled out completely and not readable, so we ask that applications be printed and legible. CTO MEMBERSHIP & AWARDS BANQUET: Rita Adamovich We would like to thank everyone who attended the 15th Annual Banquet & Membership at Romy s of Black Creek on July 22th, We had a great turnout of 170 members and guests for the awards, food, raffles and just visiting. The many donors of the raffle prizes are: Gerald Schick, Bob Schuh, Dan & Tammy Kritz, Carl Gierke, & Rita Adamovich, Gordon & Sue Decker, Dan & Brenda McFaul, Keith Hartjes, John & Angie Kempen, R. Rockman, Jeanne Bernath, Dave & Jackie Paul, and Shadows on the Wolf- Clintonville. Harland Chapman opened up the banquet by singing One Day at a Time and Todd Weyenberg led the prayer. We thank Carl Gierke and Tammy Kritz for helping MC the event. Pete 5

6 Lathrop presented the scholarships as well as the awards for the events held throughout the year. We appreciate the donations presented by Gary Vanden Heuvel on behalf of Whitetails Unlimited, Diane Stump-Jordan who donated back the 50/50 raffle, and other donations by Gregory & Gloria Shermo and Anthony & Jane Schillinger. Special thanks to anyone who helped in any way. It is very much appreciated by the committee, Rita Adamovich, Karen Baehr, Carl Gierke, Tammy Kritz, Adamovich, and Fred Kaun. Night at the Races Recap: Adamovich: August 17th was a rainy evening, but 24 Challenge the Outdoors members came to enjoy an evening at the races at the Wisconsin International Raceway in Kaukauna. At the start, rain caused the track to be wet and they had to dry it off before they could start the races. But once they started, they completed all the races so there is no rain date. Thank you all for coming. We can hope for better weather next year. Lake Michigan Recap: Doug Thiele On July 31 st, 19 CTO members and helpers set out on Lake Michigan for some salmon and lake trout fishing. After a few mix-ups as to who goes where, we were off at 4:30 am. After all his hard work putting the trip together, you might know Jerry Schick would have to catch the biggest fish- a 35 ¾ King Salmon. CTO members were also blessed with 16 other fish, most of which were some good-sized lake trout. It was a beautiful day and a good time to meet other CTO members. The 1st place wooden trophy that Jerry made went to Lauri Dubord after a drawing of 2nd place winners. Congratulations Laurie and the other members who caught fish. By the way, this was my fourth time out with no fish so don't get on my boat next year. All kidding aside, it was a great day for all of us. Thank you Jerry for your hard work. 6 For Sale-Acorn Chairlift-the maximum number of steps on this unit is 15 but can be adjusted to whatever your needs are. Everything is included except installation. Installation is very simple. $1, Call Gary Vanden For Sale GRAND CARAVAN SXT BRAUN ENTERVAN FOR DISABLED - $24995 (APPLETON) REAL CLEAN CARAVAN BOUGHT NEW BY ME. FULL MAINTENANCE RECORD, HAS WHEEL CHAIR RAMP AND HAND CONTROLS, 2 EZ LOCKS TO HOLD WHEELCHAIR, COOPER TIRES, ALL NEW BRAKES WITH CERAMIC PADS. 61,000 ORIGINAL MILES. POWER EVERYTHING, MP3 PLAYER, INTERSTATE AGM BATTERY, WAS SPARED NOTHING. 3.8 V6 6 SPD AUTOMATIC, NEEDS NOTHING. Call , ask for Rene. Wheel Chair and Handicap Transportation Solutions If you are in need of a vehicle that can transport individuals who are in a wheel chair or handicapped, please consider these two companies that serve our area. If you check out their website or give them a call, they can answer your questions for you and possibly get you out of the house and rolling along Wisconsin s scenic highways. A&J Mobility, Phone, , Website, Wheelchair Getaways of Wisconsin, Phone, , Website,

7 7 CTO Calendar of Events for 2017: Month Date Time Event/Location Contact Sept Oct Nov Dec am-4 11am 10am 6pm 8am-4 9am-12 10am 11am 6pm 8am 11am 6pm 11am 6pm Youth and Ladies Day, J&H Game Farm, Navarino Tuesday Shoot, J&H Game Farm, Navarino Outagamie Conservation Club End of Summer Get Together, Hortonville Board Meeting, Options for Independent Living, Green Bay Shoot Till You Drop, J&H Game Farm, Navarino Wheel Chair Wash, Options For Living, 555 Country Club RD. Green Bay Disabled Deer Hunt, Town of Lessor Hall Tuesday Shoot, J&H Game Farm, Navarino Board Meeting, American Legion, 3220 W College Ave. Appleton Fall Pheasant Hunt, J&H Game Farm, Navarino Wheel Chair Pheasant Hunt, Oxford, WI Tuesday Shoot, J&H Game Farm, Navarino Board Meeting, American Legion, 3220 W College Ave. Appleton Tuesday Shoot, J&H Game Farm, Navarino Board Meeting, American Legion, 3220 W College Ave. Appleton J&H Game Farm Rita, Karen Carl Keith Pat Carl Wayne Smith Carl Check for other dates. Click on the date for more information about these events in the newsletter. Contact Phone Numbers: Carl Gierke and Rita Adamovich Tammy Kritz Karen Baehr Keith Pamperin Pat Nieuwenhuis Wayne /Robin Smith J&H Game farm CTO Officers and Board of Directors: Name: Position: Phone Number: Address: Carl Gierke President cgierke1@outlook.com Adamovich Vice Pres jimrita0208@yahoo.com Doug Thiele Treasurer dougthiele48@gmail.com Tammy Kritz Secretary dantam2006@sbcglobal.net Karen Baehr Director Pat Nieuwenhuis Director nubby009@aol.com Fred Kaun Director fkaum@me.com Mike Filipenko Director lakemyk@aol.com Judy Paluch Director pali22@att.net Tom Narmore Director narmore1988@yahoo.com Keith A.Pamperin Director kjpamperin@aol.com David Paul Director dcp7576@gmail.com Dave Samsa Director psamsa@new.rr.com Robert Schubring Director r.schubring@yahoo.com Gary Vanden Heuvel Director glvanden15@hotmail.com Mark Baehr Associate Director baehrm@sbcglobal.net Bill Mayville Associate Director bill.mayville@yahoo.com Steve Nooyen Associate Director snooyen@homeinstead.com Calvin Richtig Associate Director calvinr@optionsil.org Carl

8 8 -CHALLENGE THE OUTDOORS, INC. -- MEMBERSHIP APPLICATION- PLEASE PRINT DATE 1 or 2 ADULT(S) NAME(S): ADDRESS: CITY: STATE: ZIP CODE: PHONE - - TO RECEIVE THE NEWSLETTER CHECK ONE BOX ***THE DUES ARE TO BE PAID YEARLY IN THE SAME MONTH (EACH YEAR) THAT YOU JOINED*** One-Year Individual Membership--one person -----$20 One-Year Family Membership $30 Adult(s) with children living at home ages 18 and under (if child is disabled, there is no age limit) Lifetime Individual Membership--one person------$100 Lifetime Family Membership $150 Adult(s) with children living at home ages 18 and under, (if child is disabled, there is no age limit) PLEASE CHECK THE BOXES PERTAINING TO YOU DISABLED PERSON NEW MEMBERSHIP RENEWAL MEMBERSHIP VOLUNTEER Sponsorship $200 Allows any disabled person of the sponsor's choice, and an assistant (if needed), to attend any available CTO event. IN THE FAMILY MEMBERSHIPS WITH CHILDREN WE NEED ALL THE CHILDREN LIVING AT HOME (THAT ARE 18 YEARS OLD AND UNDER) LISTED BELOW LIST THE CHILDREN S NAMES, AGES, AND; IF ANY ARE DISABLED, PLEASE PUT A CHECK BY THEIR NAME. NAME AGE IF DISABLED NAME AGE IF DISABLED INTERESTS: Hunting Fishing Volunteering Other Due to financial need, I request to be considered for a one year sponsored single, disabled membership. Please explain reason RETURN THIS FORM & THE DUES TO CHALLENGE THE OUTDOORS, INC. HOME INSTEAD SENIOR CARE 901 ANDERSON DRIVE GREEN BAY, WI ADULT(S)-PLEASE SIGN HERE & PUT THE DATE AT TOP OF PAGE NOTE: BY SIGNING THIS APPLICATION, YOU ARE GIVING PERMISSION FOR US TO USE YOUR PICTURE(S) IN THE PLACES WE MENTION HERE. We take pictures at all our events for use in our organization's advertising, displays at events, our web page, in newspaper and magazine articles and in our brochure.-- All internet addresses and pictures are used by our organization, CHALLENGE THE OUTDOORS, INC., ONLY. We do not give out any addresses or pictures to anyone else. CHECK OUT OUR WEBSITE AT office phone number is

9 9 TO SEE IF THE ITEM QUALIFIES, PRE-APPROVAL IS RECOMMENDED BEFORE YOU PURCHASE THE ITEM -- CHALLENGE THE OUTDOORS--ADAPTIVE EQUIPMENT APPLICATION DATE: PHONE NUMBER NAME: ADDRESS: CITY: STATE ZIP CODE PLEASE PUT YOUR SIGNATURE HERE-- WHAT ITEM ARE YOU ASKING TO BE CONSIDERED FOR ADAPTIVE EQUIPMENT REIMBURSEMENT? WHAT IS THE ITEM GOING TO BE USED FOR? HOW HAVE YOU SUPPORTED CHALLENGE THE OUTDOORS DURING YOUR MEMBERSHIP OVER THE LAST YEAR(S)? PLEASE EXPLAIN. * *If you receive money help, you have an obligation to give back by giving your help to our organization. CHALLENGE THE OUTDOORS ADAPTIVE EQUIPMENT RULES: All required The Adaptive Equipment program applies to hunting and fishing equipment and is for disabled members only. Approval will be done by the committee or the board of directors at a board meeting. You may receive only one Adaptive Equipment reimbursement one time per year. The year runs from January 1 to December 31. You must be a paid member of CTO for one full year before you are able to use the adaptive equipment program. You must be paid up-to-date on your dues You must provide CTO with the original receipt, and the receipt must provide the name of the store, address, phone number, current date, and cost of the article. Written or adjusted receipts are not accepted. You must completely fill in and sign and date the application for it to be considered. The reimbursement is to be 1/2 the cost of the item up to a maximum of $100. For those items that need to be made adaptable, only the adaptable part is considered for program PLEASE DO NOT WRITE BELOW THIS LINE ADAPTIVE EQUIPMENT ACCEPTED Do not cut apart ADAPTIVE EQUIPMENT DENIED IF DENIED, THE REASON NOTE: Please return this application and original receipt to our Office at this address: Challenge The Outdoors, Inc. Home Instead Senior Care 901 Anderson Drive Green Bay, WI *For questions or to see if your item qualifies, please call Pat at Version made April 17, 2017