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First Responder Warrior Registration

Enroll police officers, firefighters and paramedics hurt in the line of duty into your outdoor recreation and support programs. Captures personal details, an emergency contact, hunting and fishing background, and a signed consent.

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Page 1

Name*

Nombre

Apellido

Email*

Phone number*

Date of birth*

Sex*

Female Male Prefer not to say

Address*

Dirección

Ciudad

Estado / Provincia

Código postal

Branch of service*

Police Fire service Emergency medical services Military Corrections Emergency dispatch

Organization*

Rank

Status*

Active duty Retired Medically retired Reserve

Upload option if your ID is not available.

Max 10 MB per file

Page 2

Name*

Nombre

Apellido

Relationship*

Phone number*

Page 3

What did you love doing as a child?*

Outdoor adventures Team sports Fishing Hunting Building things Other

Hobbies and interests*

Hunting Fishing Hiking Shooting sports Camping Other

Have you hunted before?*

Yes, many times Yes, a few times No

Have you completed a hunter safety course?*

Yes No Not sure

Game harvested*

Deer Turkey Waterfowl Small game Big game None

Have you gone fishing before?*

Yes, often Yes, occasionally No

Aquatic activity

Freshwater fishing Deep-sea fishing Kayaking Boating None

Factors we should consider*

Mobility limitations PTSD support Dietary needs Medication schedule Service animal None

Page 4

Participant consent

Consent statements*

I accept the risks inherent to outdoor activities I authorize the use of event photos and videos I agree to follow the program rules

Participant name

Nombre

Apellido

Digital signature

Sign here

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