Goose & Duck Hunting Interest Form
Your Information
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
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
Date
Honorably Discharged?
*
Yes
No
Hunting Information
Have you hunted before?
*
Yes
No
Under federal law, are you allowed to possess a firearm?
Yes
No
Do you have a shotgun or do you need to borrow one? Please note: gun can only hold 3 shells for this hunt)
*
Own
Need to borrow
If you own a shotgun, what gauge is it?
*
Do you possess a current hunting license?
*
Yes
No
Do you own waders if this is a water hunt?
*
Yes
No
Are you interested in bringing a family member or friend along for the hunt? Please note, not every hunt allows a plus one
*
Yes
No
If this is a water hunt, what is your life jacket size?
*
Small
Medium
Large
X-Large
XXL
XXXL
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 Relationsip
*
Comments or questions?
Waiver & Signature
Signature
*
Today's Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: