Contact Information Rice Creek phone: Website:

Similar documents
2018 River Falls Days Parade Registration Form

Non-Typical Outfitters Spring Creek Rd. Pearl, IL Phone:

SANTA FE CLIMBING CENTER LLC SUMMER CAMP REGISTRATION FORM (Please complete and print legibly)

o Member Information Form o Waiver o Allstar Prep Assessment form, including a 4x6 picture attached to this form. Please follow

Midwest Cheer Elite- Cleveland All-Star Full Travel Cheerleading, Contemporary, Hip Hop & Pom

Dear 8 th grade students and guardians,

Midwest Cheer Elite Limited Travel Cheerleading Teams

Junior Sailing Camp. P.O. Box West 2 nd Street Essington, PA

Midwest Cheer Elite Half Season Cheerleading & Dance Teams

Have fun while learning the basic skills, techniques and rules of golf. Beginners and Advanced Players ages 5-15

Cedars Kids Club. Choose July or August 4-week Session. Mondays & Wednesdays 9am 12pm (Instruction) Thursdays 4-6pm (Tournament, Play & Prizes)

D-N-D Flyers Tryout Packet

Soccer the Brazilian Way 2018 Camp. Announcing our shore Residential Camp

Rush Copley Health-Plex Lock-In!!! Lowaneu Allanque Lodge is Inviting You!

Application 2018 Montana TU Conservation and Fly Fishing Camp

JUNIOR GOLF JUNE - AUGUST 2013 REUNION GOLF AND COUNTRY CLUB

June 11 th 15 th, Information & Registration Packet

Lima Family YMCA - Lima, Ohio

Tennessee Wildlife Federation s 2019 Youth Hunt. Hold Harmless & Release Agreement

Session 1: Session 2: Session 3: Session 4: Session 5: Session 6: Session 7: Session 8: Session 9:

Land of Lakes Open Judo Tournament - October 13, 2018

Land of Lakes Open Judo Tournament - October 13, 2018

After School Registration

STUDENT INFORMATION. Summer Camp Course Information

EASTWOOD YOUTH LACROSSE

July REGISTRATION FORMS. Chesapeake Summer Camp Enclosed Forms Parent Should Complete and Return: Enclosed Information Parent Can Keep:

Welcome. Family Outdoor Day. on Saturday, June 1, 2013 at. Hunting Hills in Dilliner Pennsylvania!

Island Surf and Sport Flagler Beach Surf Camp 2015

SUMMER DAY CAMP 2017

DYNASTY CHEER & TUMBLING PREP CHEER TEAM INFORMATION PACKET

DENVILLE RECREATION 2014 SKI & SNOWBOARD PROGRAM

Sunshine Kids Club Camp

Riding Lessons Contract For Adults

Contract for SCN 2016 Summer Off-Ice Training Programs Contract Period June 20, 2016 September 2, 2016

First Name Last Name Date of Birth / / Complete Address Home Phone Cell Phone

FALLS CREEK 2017 STUDENT PACKET

Cary-Grove High School

2014 SUMMER CAMP POLICIES & GUIDELINES

WALKATHON SATURDAY OCTOBER 02, 2010 PROVINCIAL AUTISM AWARENESS DAY

Canyon Rio Rafting Upper Salt River Day Trip Information Packet

2018 C.Y. Taekwondo Championships Sports Iowa nd Lane, Ames, IA

Please note: Campers with incomplete/missing forms will not be allowed to participate in REC Kids Camp. You do not need to submit this page.

Special Angels are a Gift from Heaven

Alcatraz 2009 Preliminary Information Meeting: Saturday October 18, 2008 DC Ranch Village 6:00-7:00PM N. Thompson Peak Parkway, Scottsdale

Pawtucket & Providence Figure Skating Club Associate Membership Application

Hanabi Judo Olympic Week Training Camp

TRIBE Rugby Waiver East County Rugby Football Club (TRIBE Rugby)

Bellingham Yacht Club Youth Sailing 2015 Medical Waiver Form and Class Registration

SUNDAY, SEPTEMBER 9, For School Age Kids with Movement Disorders

Western State Colorado University

Just Hoop Basketball

Ft Johnson Estates Swimming Pool Club 2017 Rules, Regulations, & Liability Waiver

2017 VYF&C REGISTRATION CARD

DANCER S DREAMS DANCE STUDIO FALL SCHEDULE

2018 HMBYC Youth Sailing Camp. Gender: Height: Weight: First Parent s Name: Second Parent s Name: Mailing Address: Mailing Address:

DYNASTY ALLSTAR CHEER PREP CHEER TEAM INFORMATION PACKET

Children s Summer Programs

Race Guide. Indianapolis. Check-In Party. Be Happy. Be Healthy. Be You. Welcome to The Color Run! Location: Time: What s in the Packet?

Pasadena Figure Skating Club www. pasadenafsc. com

About the program... Our Mission...

CONTESTANT APPLICATION

Registration Packet All forms must be read, completed, and understood.

ALL STAR CHEERLEADING OVERVIEW

For more information, please contact the Sea Kayak Program Manager at ext. 13 or

Midwest Cheer Elite Toledo All-Star Cheer Full Travel Information

YOUR INVITED TO TRYOUT FOR TEAM IGLOO

MIDDLE TENNESSEE STATE UNIVERSITY CHEERLEADING PROGRAM FALL TRYOUT APPLICATION

Pasadena Figure Skating Club www. pasadenafsc. com

PLAYER REGISTRATION PACKET

THE AKIYA MEMORIAL JUDO TOURNAMENT

Gymnastics Team Handbook

Independent Sportsmen s Club, Inc.

Illinois Youth Soccer Association Girls Emergency Medical Release & Liability Waiver

Contact 2: Name(s): Phones: (home) (mobile) (office) Contact 3: Name(s): Phones: (home) (mobile) (office)

73rd Annual Journal Star Summer Championship Swim Meet July 16th, 2016

THURSDAY 2018/19 SESSION 1 IMPORTANT INFORMATION FOR IP SESSION 1

The University of Kansas Mascot Squad Tryout Information Packet 2011

Aftershock Quarter Season ICE Barrington ICE ALL STARS W Northpointe Pkwy, Lake Barrington, IL 60010

Annual Tournament Texas Judo All Star Event Brown Belt State Championship

(*WINTER 18*) NUGGET SURF LESSONS / PRACTICE CLUB MEMBERSHIP Participant Agreement and Waiver of Liability

2018 New Vocations All-Thoroughbred Charity Show & T.I.P. Championships

Mail applications to: Richard Imamura 602 W. Princeton Fresno, CA 93705

High Mountain Open Judo Championship McCall, Idaho

Ski for the Health of It IMPORTANT INFORMATION

21st ANNIVERSARY OF THE ROCK & ROLL CAPITAL OF THE WORLD JUDO TOURNAMENT

JACK S DIVING LOCKER

Girls Softball Spring 2019 Ages 9 14

After School Bike Club Flying Wheels INFORMATIONAL PACKET. Wednesdays at 3:45pm 5:30pm. * no riding Nov-Feb. All skill levels welcome!

HotCheer AllStars. Items to turn in on Commitment Day. HotCheer Commitment Form. HotCheer Registration Form. Athlete Birth Certificate

TERMINATORS SELECT BASKETBALL PARENT AND PLAYER CONTRACT

Universal Judo 2018 FALL CLASSIC Judo Championships (USA Judo Sanction # 16664)

Race Guide. Arizona. Packet Pick-Up. Be Happy. Be Healthy. Be You. Welcome to The Color Run! Road Runner Sports 43 S McClintock Dr Tempe, AZ 85281

THURSDAY 2018/19 SESSION 2 IMPORTANT INFORMATION FOR IP SESSION 2

Iowa State Judo Championships

Boy Scout Troop 39 Matthews United Methodist Church 801 South Trade Street Matthews, NC 28105

DESCRIBE ANY MEDICAL PROBLEMS OR INJURIES

MIDDLE TENNESSEE STATE UNIVERSITY CHEERLEADING PROGRAM TRYOUT APPLICATION

guide Youth Aquatics Spring into Action Spring 2019 Table of Contents

A Fundamental All-Star "Exhibition Team" for athletes ages 5-8 years old

MUTTON BUSTIN APPLICATION

Transcription:

2017 RICE CREEK Located on the 1500 Acre Hunting Club at Rice Creek near Little Falls in Central Minnesota Contact Information Rice Creek phone: 320-745-2232 Email: ricecrk@brainerd.net kristacrk@brainerd.net Website: www.ricecreekhunting.com Visit us on Facebook/Rice Creek Phone between 8:00 am to 12:00 pm Tuesday-Friday 320-745-2232 16543 Game Farm Road Little Falls, MN 56345 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

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 320-745-2232 Fire ArmS SAFety (Youth ages 11-13) - cost is $645.00 6pm 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 $645.00 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 $645.00 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 320-745-2232

I am interested in attending Rice Creeks Hunting & Shooting Camps. Please Send me Information: Name Address Phone # Email 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 11-14 - Cost is $645.00 Advanced Hunter Youth Ages 12-15 - Cost is $645.00 Pro Advanced Hunter Youth Ages 15-17 - Cost is $645.00 My son/daughter would like to attend the Pro Advanced Hunter Shooting Adventure Must be 15-17 years of age. (6 p.m. Mon 7/31/17 to 10:00 Fri 8/4/17) I have enclosed a $150.00 deposit I have paid in full Send To Rice Creek 16543 Game Farm Rd Little Falls, MN 56345

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) 745-2232 Gregg s - (320) 630-3170 Joe s - (320) 630-4842 Krista s (320) 360-0491

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 8:30 12. 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 :

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:

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 Email: 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:

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.)