MāHUNT® APPLICATION FORM NO. 3
GEP (Hunting/Trapping Allowed)

Free Draw
 Three Days (Friday-Saturday-Sunday)
Name of Applicant:

_________________________
Address:
_________________________
_________________________

 Name of Companion:

_________________________
Address:
_________________________
_________________________
Telephone Number of Applicant: 
(Daytime)______________      (Evening)______________
  Name of MāHUNT Property Requested:

Check Requested
Property Below

 Preference Rank of this Application
  MāHUNT Dunn #1 ___ 1 ___ 5 ___
MāHUNT Dunn #2 ___ 2 ___ 6 ___
MāHUNT Dunn #3 ___ 3 ___ 7 ___
MāHUNT Dunn #5 ___ 4 ___  
Dates Requested: ______________ through ______________

Age of Applicant: ____ Age of Companion:____

Attestation: I hereby acknowledge and represent that I have read and will abide by the attached Rules/Log Book, including its Specific Property/Habitat Restrictions and Warnings for the property chosen above, and agree to sign the Hunting Log Book and complete the Hunting Log Book questionnaire in its entirety, located on the property near the entrance when entering or exiting such property. I further attest that I have not been convicted of any crime set forth in the Admittance Process and Free Draw Procedures description and instructions of MāHUNT.
APPLICANT

___________________________
Signature

  

______________
Date

 COMPANION

__________________________
Signature

  

____________
Date
 
Co-Signed if necessary:  I am the adult guardian of the above Companion, by my signature below, and hereby approve of and accept all responsibility for his or her actions on the property and to accompany and proximately supervise him or her at all times while he or she is on the property.
Applicant

____________________________
Co-Signature

   Companion

___________________________
Co-Signature

  

___________
Telephone

 (Application Must Include a Signed and Completed Waiver and Release)
(See below)

 

 


 

Waiver and Release
(For Application No. 3)
      In consideration for being permitted admittance to this MāHUNT property, the sufficiency of which is hereby acknowledged, I hereby agree to the following Waiver and Release. I acknowledge that recreational activities involve inherent risks, hazards and dangers that cannot be eliminated. I UNDERSTAND THAT THESE RISKS, HAZARDS, AND DANGERS INCLUDE, BUT, ARE NOT LIMITED TO:

1. The risk of handling firearms and being near others that have firearms in their possession;
2. The risk of injury from ammunition and shot from guns;
3. Walking in rugged or natural country, including encounters with wildlife, animals and insects; 
4. Inclement weather conditions;
5. The risk of radio waves and falling debris from nearby radio towers; and
6. The risk of operating or being within the vicinity of another person operating a motorized vehicle or water craft.
     My participation in this activity is purely voluntary and on my own behalf. I further represent that I am over 18 years of age (or am agreeing to this Waiver and Release on behalf of a minor child as custodian for that minor child) and under no compulsion, threat or duress to participate in any activities while present at this MāHUNT property. I am entering this MāHUNT property with full knowledge of the inherent risks, hazards and dangers involved, including the risk of grave and serious injury, death and property damage, and hereby assume and accept any and all such risks of any kind or degree.
     Lastly, I, for myself, my heirs, estate, successors and assigns, hereby KNOWINGLY AND INTENTIONALLY WAIVE AND RELEASE, FOREVER DISCHARGE, INDEMNIFY AND HOLD HARMLESS MāHUNT and its related entities, their directors, officers, agents, employees, volunteers and all other persons or entities acting in any capacity on MāHUNT’s behalf, from and against any and all claims, demands, actions, causes of action, liabilities, suits, expenses (including reasonable attorney’s fees) which are related to, arise directly or indirectly out of, or are in any way connected with my presence, actions or omissions in and on the MāHUNT recreational property, and from any cause whatsoever. Any lawsuit against MāHUNT shall be filed solely in the State of Wisconsin. If any portion of this Waiver and Release is found to be void or unenforceable, the remaining portion shall remain in full force and effect. This Waiver and Release shall remain in full force and effect until revoked in writing by both myself and MāHUNT.
      THE UNDERSIGNED HAVE READ, UNDERSTOOD AND AGREE TO THIS WAIVER AND RELEASE IN ITS ENTIRETY.

______________________________
Applicant Signature

______________________________
Applicant Name & Address

______________________________
Phone & License Plate Number
____________ 
 Date
______________________________
Companion Signature

______________________________
Companion Name & Address

______________________________
Phone & License Plate Number
____________ 
 Date
Co-Signed (Where Necessary):  I am the adult guardian of the above Companion, by my signature below, I hereby approve of and accept all responsibility for his or her actions on and to accompany and proximately supervise him or her at all times while he or she is on the property.
Applicant

____________________________
Co-Signature

 Companion

____________________________
Co-Signature

• Completed and executed Application, including signed Waiver and Release, with Rules/Hunting Log Book, including Specific Property/Habitat Restrictions and Warnings, should be sent to FREE DRAW, MāHUNT at Post Office Box 628426, Middleton, Wisconsin 53562-8426.
• Applicant and Companion (if any) must attach a copy of one of the previous two years or current year’s hunting licenses or unsuccessful licenses notifications for the State where the property is located from one of the two prior years or the current year as described more fully in the Section “Admittance Process” hereof.