DISTANT LEARNING COURSE REGISTRATION
Name:

 Items needed for the course
Address:

Completion Certificate
City:

Parental Release Form 

(for anyone under 16 yrs old) 
State
Zip

Optional Items
Contact Phone: Plenty of water
Time(s) Available by Phone: Comfortable Walking shoes
Email Address: Hunting Bow & Equipment
Course Location Selection Sturgis Jul 12, 12pm to 4pm  

Tree Stand Safety Belt 
Pierre Aug 11, 2pm to 6pm 

Seasonal Clothing
Parker Aug 25, 12pm to 4pm

NO BROADHEADS

Match Code (Printed on Certificate) 

Comments:

Please list any physical limitations (i.e. trouble walking, breathing) 

You will be contacted to confirm your registration to the course