Youth Wingshooting Clinic

Youth Wingshooting Clinic

Saturday- June 10, 2023
Finding a knowledgeable instructor to teach your son or daughter how to be successful shooting moving targets with a shotgun can be challenging. We are providing you with an opportunity to spend a day together while your youth learns the basics of shotgun shooting. Taught by IDNR/NSCA Certified Wingshooting Instructors from throughout the State, this clinic takes place both in the classroom and the shooting field. Includes shotguns, shotshells, clay targets, trap machines, eye and ear protection. Lunch is provided. Limited to 20 youth- Ages 12+. No cost. Sponsored by IDNR and Gardner Camp. Registration Required.

Please note: Our group size is limited. Registration will close when our limit is reached.

Gardner Camp is a not-for-profit, private foundation established by the generosity of the late John Willis "Jack: Gardner II. Gardner Camp offers outdoor educational programming to youth in Adams & Pike County IL and surrounding counties including Hancock, Schuyler, Brown, Scott, Greene, Morgan, and Calhoun in Illinois and Marion, Lewis, Ralls, and Pike in Missouri.
Youth Participant Information
Name*

First NameLast Name
Gender*

MaleFemale
Address*
City*
State*
Zip*
County*
Date of Birth*

MonthDayYear
T-Shirt Size*
Skills Assessment Questionnaire
IDNR requires a parent/guardian signed permission form for ALL participants (under 18 years of age) and a brief skill assessment. Please complete and submit prior to the event.

Note: In addition to being at least 12 years old, boys & girls but be at least 4'6" tall and weigh 75 lbs. or more.
Current Age*
As of June 10, 2023
Current Weight*
As of June 10, 2023
Current Height: Number* feet, Number* inches.
Participant has shot at clay targets (select one):*

Never (less than 1 box of shells)Rarely (less than 20 boxes of shells)Occasionally (more than 20 boxes of shells)Often (more than 100 boxes of shells)
Parent or Legal Guardian Information
Parent/Legal Guardian*

First NameLast Name
Relation*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone*

Area CodePhone Number
Parent's Email (All event communication will be sent by email.)*
Parent/Guardian Permission Statement
I am the parent/legal guardian of: Youth Name*and I give permission for my shooting student to participate in the IDNR Wingshooting Clinic at Gardner Camp.

I understand part of the clinic will include shooting shotguns at clay targets and I hereby

specifically give permission for my shooting student to participate in that activity.

Note: The Department of Natural Resources, the Safety Education Instructor, or

the Wingshooting Instructor will remove any participant from the Wingshooting

Clinic for disruptive or unsafe behavior.

Permission given by:

My First Name* My Last Name* Today's Date*

NOTE: Gardner Camp is a Tobacco-Free Campus. NO sse of tobacco products including cigarettes and "spit tobacco" or e-cigarettes permitted within the failities or anywhere on the property of Gardner Camp at any time.

Prior to attending, you will be required to submit Waiver and Release of Liability forms for both the participant and the parent.
Signature*

Parent/Guardian Please Sign Clear
Emergency Contact Info
Emergency Contact Name (if parent or guardian is not available):*

First NameLast Name
Relation:*
Emergency Number*

Area CodePhone Number
Other Information
How did you hear about Gardner Camp?*
First Time Participant?*

YesNo
Do you need reasonable accommodations to attend this program?*

YesNo
If Yes, please describe:
NOTE: Gardner Camp is a Tobacco-Free Campus; No use of tobacco products including cigarettes and “spit tobacco” or e-cigarettes permitted within the facilities or anywhere on the property of Gardner Camp at any time.

Prior to attending, you will be required to submit Waiver and Release of Liability form.
Should be Empty:

Youth Wingshooting Clinic

Youth Participant Information

Skills Assessment Questionnaire

Parent or Legal Guardian Information

Parent/Guardian Permission Statement

Emergency Contact Info

Other Information