Ice Fishing Interest Form
Please note, you will need to purchase the required licenses as well as have a paper copy with you during the fishing trip.
Your Information
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Have you participated in an Honor and Valor Outdoors trip before?
*
Yes
No
Military History
Branch of Military
*
Army
Marines
Air Force
Navy
Other
Years of Service
*
Date of Discharge
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Honorably Discharged?
*
Yes
No
Fishing Information
Have you ice fished before?
*
Yes
No
Do you possess a fishing license? If so, you will need a paper copy for the trip.
*
Yes
No
Are you interested in bringing a family member or friend along for the trip? Please note: not every trip allows a plus one
*
Yes
No
What size t-shirt/sweatshirt do you wear?
*
Small
Medium
Large
X-Large
XXL
Emergency Contact Information
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Relationship
*
Comments or questions?
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*
Yes
No
Photo & Social Media Release
Waiver & Signature
Signature
*
Today's Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Should be Empty: