Youth Turkey Hunt Program

Youth Turkey Hunt Program - Participant Registration Form

To be completed by a parent or guardian along with the youth participant.
Use this form to register your child for the Youth Turkey Program. You will receive an automatic email confirmation when the form has been received. If you have questions, please email the program coordinator at astrid.huseby@mass.gov or visit the online guide at www.mass.gov/dfw/yath
Youth Participant's Name*

First NameLast Name
Youth Participant's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Youth Participant's Date of Birth*

MonthDayYear
Participant must be 12 to 17 years of age
Hunter Education Certificate Number
This is required to hunt, participants must provide their hunter education number to MassWIldlife before the day of the hunt.
Firearms Identification # (FID)
If the participant is 15 to 17 year of age:
MassFishHunt Customer ID#
If the participant is 15 to 17 year of age:
Youth Agreement*

I understand and agree that by signing this registration form I will follow all safety precautions as they are explained to me.
Youth Signature*

Clear
Youth Signature Date*

MonthDayYear
Date
Parent/Guardian's Name*
Parent/Guardian Signature Date*

MonthDayYear
Date
Parent/Guardian Email*
example@example.com
Parent/Guardian Phone Number*

Area CodePhone Number
Parent/Guardian's Signature*

Clear

Class Selection
Part One: Online Youth Turkey Seminar: You must attend a mandatory online youth turkey seminar. Please select the class that best fits your schedule. You must complete the online turkey seminar prior to the field day.
Note: A final list of 2021 participating clubs for the in-person field day is not yet available. As a reference, clubs that signed up to participate in 2020 are listed here. If you select a club that ultimately does not participate this year, you will be notified and asked to choose a different club.
Part Two: Field Day: You must complete a field day either in-person or online. If completing an in-person field day please select the club you will be participating with. If completing an online field day, please select the option “Online (self-paced)”.

Parental/Legal Guardian Consent Form

This consent form must be filled out by a parent or guardian.

I, Parent/Guardian Name * , the parent/guardian of Child Name* (child) desire to have my child participate in the Young Adult Turkey Hunt Program held by the Club name* , and hereby consent to my child’s participation in the program and grant the club the unconditional right to use my child’s name, voice and photographic likeness in connection with articles, press releases and audio/video productions
resulting from this event.
In giving my consent for my child to participate in the program, I understand that hunting is a sport involving firearms which, if mishandled can be dangerous and cause serious injury and/or death to my child or others. I understand and agree that my child will use utmost care during his/her participation in the program, and agree that he/she will adhere to the standards, guidelines and requirements of hunting and firearms safety. I understand and agree that my child will follow the safety instructions given to him/her by the club, its members, agents, employees, instructors and volunteers. I understand and agree that the club reserves the right to remove my child from the program if, in their opinion his/her safety or the safety of others is jeopardized. I understand and agree that I or another adult authorized by me shall be present with my child during all activities and events of the program.
Parent/Guardian Signature*

Clear
Parent/Guardian Name*

First NameLast Name
Signature Date*

MonthDayYear
Date
Parent/Guardian Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Release and Indemnification Agreement

This consent form must be filled out by a parent or guardian

In consideration for, and as an inducement to the Club Name* (club) allowing my child to participate in the Young Adult Turkey Hunt Program (program), and recognizing that my child’s participation in the program involves the use of firearms I, Parent/Guardian Name* , parent/legal guardian intending to be legally bound, hereby, for my child, myself, my heirs, executors and administrators, voluntarily assume all risks of accident, injury or death and release and forever discharge the Commonwealth of Massachusetts, acting by and through the Division of Fisheries and Wildlife within the Department of Fish and Game and its officers, employees and agents (Commonwealth), the club and their officers, agents, employees, volunteers and assigns (collectively, the parties) of and from any and all claims, debts, demands, actions, causes of actions, suits, dues, sum and sums of money, accounts, reckonings, bonds, specialties, agreements, promises, doings, omissions, damages, executions and liabilities of whatsoever kind and nature, including but not limited to any and all liability for personal injury, death or property damage of any kind, both at law and in equity, and any that have been or may be claimed before any governmental agency, which have arisen or may arise as a result of or in association with my child’s participation in the program.
I hereby further covenant and agree that I shall save the parties harmless and shall indemnify the parties from and against any and all claims, liabilities and costs for any personal injury, death, property damage or other damages and loss that arise directly or indirectly out of or in connection with my child’s participation in the Massachusetts Young Adult Pheasant Hunt Program, including but not limited to the parties’ negligence, reckless or intentional conduct. I further agree that the club shall at no time be considered an agent or representative of the Commonwealth. This hold harmless and indemnity agreement shall include indemnity against all costs, expenses and liabilities incurred in connection with any such injury, death, loss or damage or in defense of any claim or claims on account thereof, including reasonable attorney’s fees.
Release and Indemnification Agreement Signature*

Clear
Parent/Guardian Name*

First NameLast Name
Release and Indemnification Agreement Date*

MonthDayYear
Date

Medical Information

Please answer the below questions to facilitate prompt authorization of medical treatment in the case of an emergency.
Primary Doctor Name
Primary Doctor Phone Number

Area CodePhone Number
Health Insurance Company
Policy #
Emergency Contact Name
Relationship to the Participant
Emergency Contact Phone Number

Area CodePhone Number
Known allergies
Please write "none", if no known allergies
Additional Information / Special Instructions
Last Tetanus Shot

	Very Confident	Confident	Somewhat Confident	Not at all Confident
Firearms safety
Shooting skills
Hunting regulations
Choosing the right hunting gear
Scouting
Ethical shot placement
Field dressing
Butchering and preserving wild game
Cooking harvested game meat

	Greatly Increase	Increase	Somewhat increase	Not at all increase
Having someone to go with
Knowing where to go
Having a place to go
Access to equipment or clothing
Knowing the rules and regulations
Having more free time
Feeling more confident in my hunting skills
Feeling more confident around firearms
If my friends/family were interested in hunting
Lower costs associated with hunting
If I had a greater interest in hunting

Youth Turkey Hunt Program - Participant Registration Form

Class Selection

Medical Information

Youth Participant Questions