Pathfinder Fish & Game Club

Pathfinder Fish & Game Club 2012 Youth Pheasant Hunt Registration/Release Form

Childs name: ______Age: ______Address: ______City: ______, NY Zip: ______Parent or Legal Guardian’s name: ______Phone number or parent/legal guardian: (____) _____-______Name of adult accompanying child: ______

Release of Liability & Photo Release As parent or legal guardian of the child listed above, I certify that said child has y permission to attend and participate in all activities for the 2012 Youth Pheasant Hunt at Pathfinder Fish & Game Cub. By signing this form, I hereby wave and release all other participants, the host, sponsors, and all other officials or parties involved in the event from all claims and/or damage incurred n connection with this event. I also hereby grant the sponsor and co-sponsors the unconditional right to use the name, voice, and photographic likeness of the above child, in connection with any of the articles, press releases, and audio/visual productions.

______Signature of parent or legal guardian Date

Mail completed form to: Pathfinder Fish & Game; PO Box 14; Fulton, NY 13069