Contact Information Rice Creek phone: Website:

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1 2017 RICE CREEK Located on the 1500 Acre Hunting Club at Rice Creek near Little Falls in Central Minnesota Contact Information Rice Creek phone: Website: Visit us on Facebook/Rice Creek Phone between 8:00 am to 12:00 pm Tuesday-Friday Game Farm Road Little Falls, MN A Letter AbOut rice creek ShOOting Adventure Just a quick note to thank you Pheasants Forever so very much for the opportunity to send Nick Woessner and Adam Farrell to the Rice Creek Camp last week. It was an incredible week of fun and learning for both of them. Everyone involved in this program did a fantastic job teaching these young people about firearm safety and the responsibilities that go along with it. Thank you for allowing Adam and Nick an experience that they will carry with them the rest of their lives. Very truly: The Farrell and Woessner Families Call to Reserve Your Spot Today youth ShOOting Adventure

2 rice creek ShOOting Adventure We are looking to develop other shooting adventures in the future that will expand the offerings that we have. Some of the other options we are considering are father/son & mother/ daughter weekend shooting adventures and an all women s outdoor shooting adventure. We would appreciate your feedback on our camps and what you would like to see in our future offerings. OutdOOr Fun & ShOOting Rice Creek is creating the adventure your youth can t miss! It is an opportunity for youth to: Get their DNR Firearms Safety Certificate in the Beginners, held in June Visit Camp Ripley & the Little Falls Area Go on a Fishing Excursion Go Canoeing Stay at the clubhouse except for one overnight camp-out in the woods Learn about hunting dog handling and gun handling Receive sporting clays shooting instructions Shoot at and break clay targets Shoot full rounds of sporting clays in the advanced camp Muzzle loading and bow shooting Go live bird hunting Clean harvested birds in the advanced camp Eat great food, make great Friends! This is an opportunity designed to provide fun and learning with hands-on participation. There is an adult with the youth 24 hours a day. Both boys and girls are welcome. Get someone you know more involved in the outdoors. You will not be disappointed. To get signed up or for more information, call Fire ArmS SAFety (Youth ages 11-13) - cost is $ pm Sunday 6/11/17 to 12pm Friday 6/16/17 (we need 6 or more to have this camp) You will be required to have 6 boxes of low base shells. Each youth will receive cleaned pheasants to take home. Mentors and Family members will be invited to have a free lunch with us starting at 12 pm on Friday. AdvAnced (Youth ages 12-15) - cost is $ Must have their Firearm Safety Certificate 6pm Monday 7/24/17 to 12pm Friday 7/28/17 (we need 6 or more to have this camp) You will be required to have 12 boxes of low base shells. Each youth will receive cleaned pheasants to take home. Mentors and Family members will be invited to have a free lunch with us starting at 12 pm on Friday. PrO AdvAnced (Youth ages 15-17) - cost is $ Must have their Firearm Safety Certificate 6pm Monday 7/31/17 to 10am Friday 8/4/17 You will be required to have 15 boxes of low base shells. Pick up time is at 10 am on Friday If you would like to sponsor a youth or donate, please contact Gregg or Joe LeBlanc at

3 I am interested in attending Rice Creeks Hunting & Shooting Camps. Please Send me Information: Name Address Phone # My son/daughter would like to attend the Beginner s Firearm Safety Shooting Adventure 6 p.m. Sun 6/11/17 to 12:00 Fri 6/16/17 My son/daughter would like to attend the Advanced Hunter Shooting Adventure (6 p.m. Mon 7/24/17 to 12:00 Fri 7/28/17) Beginner Firearm Safety Youth Ages Cost is $ Advanced Hunter Youth Ages Cost is $ Pro Advanced Hunter Youth Ages Cost is $ My son/daughter would like to attend the Pro Advanced Hunter Shooting Adventure Must be years of age. (6 p.m. Mon 7/31/17 to 10:00 Fri 8/4/17) I have enclosed a $ deposit I have paid in full Send To Rice Creek Game Farm Rd Little Falls, MN 56345

4 Rice Creek Pro Advanced Shooting Adventyure Checklist! Sunscreen that has an SPF of 15 or higher and Sunglasses. Bathing suit Personal Hygiene items, Tooth brush, Deodorant, Shampoo (We provide soap, towels and washcloth s). Gun (12ga or 20ga) and case. We will provide a gun if needed Personal Water Bottle Tennis Shoes and Sandals Medication (with note about how it should be administered) 5 days - worth of socks and underwear Several t-shirts, hooded sweatshirts, shorts, one or two pairs of long pants, pajamas (prepare for all weather condition) warm jacket (if weather looks like it might get cold at nights) Sleeping bag and pillow for camp out Life jacket Fishing pole / Tackle (if they have one) 20 Boxes of low base shells Hunting Vest (optional) What not to Bring: Chewing gum Most camps don t allow it. It could end up anywhere, says Prime Walkman, Discman, IPod, Ipad, Video or computer games (No Electronics). That s not really part of the camp experience. We have programs planned throughout the whole day and they won t have the chance to use them anyway. Knives of any sort Do not bring snacks or sunflower seeds (we will have plenty of food for the kids) Cell phones - We would rather have the kids not bring them but if they do bring them we will keep the phone locked up and let them use it at certain times of the day. **Parents can call 24hrs per day at ** Clubhouse - (320) Gregg s - (320) Joe s - (320) Krista s (320)

5 1. Every night - Bedtime is 10:30 Quiet is 11:00 2. No Money (Pro Shop is off Limits) 3. No Hitting, No Horse Play 4. No inappropriate language 5. Wake up 8: Rooms are kept organized 13. If any of these rules are broke, they will get a warning, the second time the parents will get a call and have to pick the kid up. 14. Anything abused or broken by you on purpose will have to be replaced or paid for. 6. Changing of clothing (only in Bedrooms) 7. Cell Phone use will be Limited 8. Respect the staff and respect the equipment 9. Must be in sight of a staff member during activities 10. You are only allowed into your assigned rooms 11. Doors are kept open at all time (the only door that will be shut are the bathroom doors) Youth s Signature : Parent s Signature :

6 Dear Parent/Guardian : During your youth s stay at Rice Creek Shooting Adventure, they may encounter the need to be given some over the counter medications for various things which may range from an upset stomach to a runny nose. There is a list of over the counter medications that will be available for your children should they need to be administered due to unforeseen circumstances. Medications will be administered following the dosage levels indicated on the container. Review the list and verify your approval for each medication by checking the column next to the medication. Any you don t approve, just leave the column blank. If there are any medications not indicated on the list, but you want them available for your children, just turn them into the staff upon arrival with directions for use and they will be made available when needed. Children are not to have access to their own Symptoms Medication Approval Allergy Benadryl Antacid Tums Antihistamine Benadryl Anti - Diarrheal Pepto - Bismol Anti - Itch Benadryl Cream Cough suppressant Robitussin Cough Drops Nasal Decongestant Benadryl Internal Analgesic Tylenol Ibuprofen Youth s Name : Parent/Guardian : Date:

7 Rice Creek Hunting & Recreation Permission & Health Form PLEASE PRINT! Youth Name Date of Birth Age Male or Female Parent or Guardian Name Home # Work Cell # 1 Cell # 2 Home Address City Zip code Name of Health Insurance Policy Number Physician Clinic Name State Clinic Phone # Current Health Information on child above: Asthma or other allergies: list triggers Treatments Diabetes (Describe insulin, snacks and when to call you) Special dietary regimen or food allergies: Does your youth carry epinephrine? Bleeding Disorder Seizures (list all medications and when used) Muscle bone joint condition (list treatment) Heart Condition Sleeping Problems Date of last tetanus booster Current Medications: List any current Medications, amount given & time to be given (all medication must be sent from home it s original over-the-counter container) PERMISSION & EMERGENCY AUTHORIZATION: 1. The youth has my permission to participate in the Rice Creek Shooting Adventure 2. Rice Creek has my permission to give my child the above medications 3. Rice Creek Staff has my permission to transport my child for educational and/or emergency reasons 4. Permission is granted, in a medical hospitalize, secure treatment for, and/or order injection, a anesthesia or surgery for the camper. I understand every effort will be made to reach me at the phone # or if I can not be reached call # (directions to the contrary or additional health information must be attached to this form) 5. I believe all precautions will be taken child care and supervision. I will not hold Rice Creek Hunting & Recreation, staff, teachers, or chaperone s SIGNATURE OF PARENT OR GUARDIAN: DATE:

8 RELEASE, INDEMNIFICATION AND HOLD HARMLESS AGREEMENT In consideration of participating in sports activities, and for other good and valuable consideration, I hereby agree to release and discharge from liability arising from negligence and its owners, officers employees, agents, volunteers, participants, and all other persons or entities acting for them (hereinafter collectively referred to as Releasees ), on behalf of myself and my children, parents, heirs, assigns, personal representative and estate, and also agree as follows: 1. I acknowledge that participating in sports activities involves known and unanticipated risks which could result in physical or emotional injury, paralysis or permanent disability, death and property damage. Risks include, but are not limited to, broken bones, torn ligaments or other injuries as a result of falls or contact with other participants,; death as a result of drowning or brain damage caused by near drowning in pools or other bodies of water; medical conditions resulting from physical activity; and damaged clothing or other property. I understand such risks simply cannot be eliminated, despite the use of safety equipment, without jeopardizing the essential qualities of the activity. 2. I expressly accept and assume all of the risks inherent in this activity or that might have been caused by the negligence of the Releasees. My participation in this activity is purely voluntary and I elect to participate despite the risks. In addition, if at any time I believe that event conditions are unsafe or that I am unable to participate due to physical or medical conditions, then I will immediately discontinue participation. 3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Releasees from any and all claims, demands, or causes of action which are in any way connected with my participation in this activity, or my use of their equipment or facilities, arising from negligence. This release does not apply to claims arising from intentional conduct. Should Releasees or anyone acting on their behalf be required to incur attorney s fees and costs to enforce this agreement. I agree to indemnify and hold them harmless for all such fees and costs. 4. I represent that I have adequate insurance to cover any injury or damage I may suffer or cause while participating in this activity, or else I agree to bear the costs of such injury or damage myself. I further represent that I have no medical or physical condition which could interfere with my safety in this activity, or else I am willing to assume and bear the cost of all risks that may be created, directly or indirectly, by any such condition. 5. In an event that I file a lawsuit, I agree to do so solely in the state where Releasees facility is located, and I further agree that the substantive law of the state shall apply 6. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. By signing this document, I agree that if I am hurt or my property is damaged during my participation in this activity, then I may be found by court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim for negligence. I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel in this activity would be significantly greater if I were to choose not to sigh this release, and agree that the opportunity to participate at the stated cost in return for the execution of this release is reasonable bargain. I have Read and understood this document and I agree to be bound by its terms. Signature Address Print Name City State Zip Telephone Date: PARENT OR GUARDIAN ADDITIONAL AGREEMENT (Must be completed for participants under the age of 18) In consideration (PRINT minor s names) being permitted to participate in this activity, I further agree to indemnify and hold harmless Releasees from any claims alleging negligence which are bought by or no behalf of minor or are in any way connected with such participation by minor. Parent or Guardian Print (If notarization is necessary, please sign & stamp this side of form.)