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Congratulations!

You registered for our hog hunt monthly giveaway on our website at: 

www.independenceranch.com 

 and your e-mail has been drawn as one of our monthly winners for the  hog hunt giveaway! Congratulations!

 

You can claim your hunt by following the instructions below. 

 

Please claim your hunt within 14 days of being notified or the prize will be given to the Runner-up   

 Here are the details of the hog hunt you have won:

 

 This hunt is a 3 day, 2 night hunt, Ranch Boss ~ hog hunting package that you have won; value $1199.

Your hunt can be scheduled any available start day except Fridayfrom now until December 15, 2018!

If you schedule your hunt on one of our Summer "Special Sessions" that we use for hog control, (Summers Only) Your limit of 2 hogs is lifted.  You will be able to shoot unlimited hogs, unlimited sizes which include the Monster Hogs!

You are responsible to pay the hog cleaning fees on all hogs shot.  If you don’t want that much meat, we can donate, but you are still responsible for the hog cleaning fees.

 

Please claim your hunt within 14 days of being notified or the prize will be given to the Runner-up   

 

(Our regular hunting season is closed from June 15 to September 15 each year.)

 You do not have to have your hunt dates picked out in order to claim your hunt.

 

 You can attend this hunt alone, or you can bring your hunting buddies along!

 

 

Only 1 drawing winner per family or group please.

As the winner of this hunt, you can bring your buddies along, and we will discount their hunt as follows: ( Regular price is $799 each.)  This Hog Hunt package cannot be combined with other customers or discounted hunts except as follows:

  

  • IF YOU PAY FOR ADDITIONAL HUNTERS WITHIN 7 DAYS OF CLAIMING YOUR HUNT, YOU CAN ADD ADDITIONAL HUNTERS FOR $399 EACH.
  • IF YOU PAY FOR ADDITIONAL HUNTERS WITHIN 8-14 DAYS OF CLAIMING YOUR HUNT, YOU CAN ADD ADDITIONAL HUNTERS FOR $499 EACH.
  • IF YOU PAY FOR ADDITIONAL HUNTERS AFTER 14 DAYS OF CLAIMING YOUR HUNT, YOU CAN ADD ADDITIONAL HUNTERS FOR $599 EACH. 
  • Click here to add hunters: http://texas-hog-hunts.myshopify.com/products/booking-fee

 

IF YOU ADD ADDITIONAL HUNTERS WITHIN 7 DAYS OF CLAIMING YOUR HUNT, WE WILL ALSO ALLOW EACH HUNTER TO SHOOT UNLIMITED PIGLETS UP TO 50 LBS EACH.  YOUR ONLY COST WILL BE $75 PER PIGLET FOR GUT, SKIN, AND QUARTERING. (Regular kill fee for piglets is $100 ea. + cleaning)

 Once you have claimed your hunt, you can add your hunters anytime in the future. ( Discounts will vary, based on purchase date.) Click here to add hunters:http://texas-hog-hunts.myshopify.com/products/booking-fee

 

We will be hunting day and night, so bring your predator calls, and spot lights.

 

 THIS IS WHAT YOU HAVE WON!

 Included in the hunt:

(Ranch Boss ~ Hog Hunting package : $1199 value):

  • Unlimited hogs, only pay butcher!
  • Day & night hunt sessions
  • All meals & drinks
  • Lodging

Not Included:

  • non-resident license ($48) Purchase at any Texas Walmart. Residents pay less. If you were born after Sept 2, 1971, you will need a hunter safety class from your State, or you can buy a hunter safety deferment for $10 with your license.
  • hog cleaning per hog is $75 for hogs up to 50 lbs; Service also included field retrieval, cutting the bigger hogs into 10 pieces, freezer/cooler space. Cleaning for hogs bigger than a piglet is $1.50/lb.
  • Guide/Staff fee $100, collected in cash upon arrival
  • gratuity for your staff
  • booking fee ($99) No booking fee for addit'l. hunters.

  • If you schedule your hunt on one of our Summer "Special Sessions" that we use for hog control, (Summers Only) Your limit of 2 hogs is lifted.  You will be able to shoot unlimited hogs, unlimited sizes which include the Monster Hogs!
    You are responsible to pay the hog cleaning fees on all hogs shot.  If you don’t want that much meat, we can donate, but you are still responsible for the hog cleaning fees.

 

NOW HERE IS THE SUPER BONUS!!!
 
Bring at least 1 other hunter with you when you use the hunt you have won and you will qualify to use the SUPER BONUS HUNTS afterward. 
 
You can purchase multiple hunts for only $99 ea!  Wow! This purchase is a one time offer that can only be purchased when you claim your hunt.  It must be purchased on the same invoice that you pay your $99 booking fee on. Not valid to purchase later.
 
Here are the details of what $99 buys:
 
It is the same 3 day hunt as listed above except it includes UNLIMITED HOGS AND UNLIMITED SIZES! ( please note the “not included” services listed above that will apply )
The $50 hunts must be used on a separate trip after you and your other added hunter(s) use the hunt you have won.
Buy all you want, use yourself or give them away as gifts, as you only have 1 opportunity to take advantage of this deal.  IT CANNOT BE ADDED LATER.



* REGISTER AND CLAIM YOUR HUNT HERE

Please claim your hunt within 14 days of being notified or the prize will be given to the Runner-up   

How to claim your 3 Day hunt worth $1199 by paying your $99 booking fee:

 

  • You can pay on our Shopify secure checkout by clicking here: http://texas-hog-hunts.myshopify.com/products/booking-fee
  • Some hunters want to talk to a real person before purchase.  You can talk directly to the Ranch Boss (owner of the Ranch) on his personal Cell   ( Please read all material provided before calling.) @ 832-419-6151 prior to making your purchase.

 

 

You do not have to have your hunt dates picked out in order to claim your hunt. Please carefully read this entire page before calling the ranch with questions, or to claim your hunt.

 You can still claim the hunt even if you have already purchased a hunt. This hunt will have to be used on another hunting trip, and cannot be used at the same time as any other previously purchased hunts or with any other hunt winners. You can add hunters with your hunt, at the discount rate mentioned in this e mail.

 

You can only claim 1 hunt per 3 years, in our draw.

 

 Please carefully review the FAQ page, so as to be best prepared. After carefully reading this entire page, you can call the ranch with additional questions at 832-419-6151.

Congratulations on the drawing, and please claim your hunt before the deadline expires. 

www.independenceranch.com

 

__________________________________________________________________________________________________________

.Physical Address:  Gps will not get you to the gate. Please follow the directions below

 

9537 Texas 97, Waelder, Tx.  78959

 

Lat:  29.61458  Lon:  -97.326314

 

 

Directions from San Antonio

Travel East on I-10 approx. 85 miles and take exit #649. Turn Right on Highway 97 and travel exactly 4.0 miles. Enter gate on the left. Wait at the next locked gate until your guide meets you at your appointed check in time. No early check in. Please park off to the side, keeping the driveway clear. See you soon at the ranch!

 

Directions from Austin

 Take highway 71 toward Bastrop. As you are entering Bastrop, you will see an auto dealership with a giant American Flag on the right. ( There is a walmart one mile straight ahead on highway 71, if needed.) This is highway 304. Turn Right and travel approx 30+ miles to I-10. Turn left. Take the next exit, which is exit #649. Turn right on highway 97 and travel exactly 4.0 miles. Enter gate on the left. Wait at the next locked gate until your guide meets you at your appointed check in time. No early check in. Please park off to the side, keeping the driveway clear. See you soon at the ranch!

 

Directions from Houston

Travel west on I-10. You will travel approx. 90 miles past Katy, Texas. You will take exit #649 and turn left. This is Highway 97 and you will travel exactly 4.0 miles. Enter gate on the left. Wait at the next locked gate until your guide meets you at your appointed check in time. No early check in. Please park off to the side, keeping the driveway clear. See you soon at the ranch!

 

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 Ranch Frequently Asked Questions

 

last updated 03/18/15

 

  

1. Why does the Ranch provide a FAQ?

It is our desire that each hunter experience the best time possible. In order for us to help our hunters have a good time, we have provided this information. It is required that each member of your hunting party carefully read the FAQ, so as to be best prepared.

2. Would you like to own your own Ranch? 

 

Our professional staff can locate, purchase, and help you set-up the ranch of your dreams. Please call to inquire. 

 

3. What is the preferred weapon for hunting?

Since most of the hog hunting is done in thick brush, a open-sight shot gun with a slug or open-sight rifle is the preferred weapon, from April thru November. No buck shot is allowed on the ranch.  Scoped rifles or shotguns are recommended the rest of the year.  Rifle size required minimum of .243 or .270, .30-.30, .308, .45-.70 or bigger.  Bigger rifles will work but not necessary.  For all guns, we have a 3 round rule; 1 in the chamber and no more than 2 in the clip regardless of clip size.  Pistols, bows, and crossbows are also effective. 

4. What Hunting Dates are available?

See Calendar of Available Dates on the website

5-7. Coming Soon

8. Is this a guided hunt?

The hog hunts are semi-guided, exotic hunts are fully guided.  Your guides will direct you to the blinds, pick up your game, and advise you on the best hiding places to typically find hogs on your spot and stalk.  Some hunters prefer to drive their own vehicle to the blind, and this is allowed.   All exotic hunts are fully guided, unless other arrangements are made.

9. What type of clothes should be worn?

In Texas, you always have to be prepared for wet weather. You will want to bring waterproof boots in the event of bad weather. In fall, winter, and spring, be prepared for cool to cold weather. In the summer months, you will need to dress light. Bring your sunscreen.

10. What do I need to bring with me?

If you are driving to the ranch, please bring your bedding, towels, and toiletries. If you are flying, the bedding and towels will be provided. Bring appropriate clothing and your weapons. Cell phones are highly recommended and work well on the ranch, except T Mobile. Battery operated flashlights are required if you plan on hunting at night. Bring your predator calls and night vision (optional). It is recommended that you bring bottled water to carry with you in the field.  Hunter Orange vests & hats are required to be worn by all hunters while on the ranch. Purchase 100 lbs of sweet feed, grain, or cracked corn (not whole corn) per hunter,prior to your arrival. Or, you can purchase your grain at the ranch during check-in.  Click here to see video.  The feed is used to bait the hogs while you are hunting from a blind. 

11. Is a freezer and ice available at the ranch?

Ice is available at the ranch. We also have a freezer available to keep your animals cold prior to your departure.

12. Is there much walking?

Sometimes there can be. If we are tracking the hogs in the creek bottoms, it is all walking. It is common to walk 5-10 miles per day.  You will also walk into your hunting areas. 4-wheelers can scare the game away.  For those that prefer to limit walking, your guide will accommodate you.   There are stands and blinds on the ranch for those that prefer not to spot and stalk. To increase your hunting odds, you may consider reserving a hunting session in the "Honey Hole!" Click here to reserve:  http://texas-hog-hunts.myshopify.com/products/private-cabin

13. What type of hunting license do I need?

For hogs, cats, varmints, and exotics, non-resident hunters will need a non-resident 5-day special hunting license (type 157) which can be purchased at any Texas sporting goods store or Walmart for $48. Texas residents will also need a $25 general hunting license.Under 17 is $10. If you are hunting turkey or whitetail deer, you will need a different license. Please refer to the Texas Parks and Wildlife link on our website for more details.

Texas Parks and Wildlife

 

14.  Is Hunter Safety Required?

Very Important!

  http://www.tpwd.state.tx.us/learning/hunter_education/required.phtml

15. Coming Soon.

16. Is there a taxidermist for the mount?

Yes. The trophy will be shipped to your home.

17. Can someone clean and quarter my animal?

It is mandatory that the ranch skinners handle the cleaning of any animals harvested on any of our ranches. 

Hog Cleaning per hog is $50 to gut and skin hogs 50 lbs or less. Cost is $1.lb thereafter. Bigger hogs are cut into 10 pieces, and ready for the cooker!  This service also includes retrieval from the field, freezing or chilling the meat, and packaging in ice at your departure.

Any hog shot and not recovered will incur a $50 recovery/disposal fee, and will count against your harvest, or will be charged as an additional kill at an additional cost.

Exotic animals Cleaning (gut, skin, and quarter) $75.00 to $150.00, depending on size of animal.

Animal Caping for Mounting $25-75. The higher end is for large exotics. Hogs are on the lower end.    

 

18. Can I take my animal back home if I am flying?

Yes. Your meat can be packed in a cooler and taken home on your flight.

 19. Coming soon

  20. What do I need to know when flying with my weapons?

All airlines allow guns to be flown with the luggage. Pack your guns and ammo separately.

Your guns will be inspected. Pack your guns well.

 

21. Where is the ranch located?

Most hunts are taken from the main lodge ranch of 265 game-fenced acres, near Gonzales Texas.  When available and when booked in advance, additional ranches located in Gonzales County, Texas and/or Fayette County, Texas can be hunted for a trespass fee of $49/hunter/ranch.  Additional kill fees of $100.00/hog apply, with no additional trophy fees for larger hogs.

22. What airport should I fly into?

You can fly into Austin at 65 mile away, or San Antonio at 90 miles away, 2nd choice.

23. What other costs should I expect once I'm on the ranch?

Please allow for animal cleaning, guide/staff fee of $100/hunter, and gratuities.  Any balances due, are to be paid in cash only at check-in. Only additional trophy hunts can be paid with credit card.  No checks.

24. Do I need to rent a car?

Yes. Because of the distance, we are not able to pick you up.

25. Can I add days to my hunt?

Yes, you can also book a 5 day hunt. The cost is double that of a 3 day hunt.

26. What other animals can I hunt, and what is the cost?

We have several varieties of rams, axis deer, fallow deer, red deer, sika deer, scimitar-horned oryx, blackbuck antelope, bison buffalo, water buffalo, hogs, dove, turkey, and whitetail deer. The ranch has over 3 miles of game-fence.  Most exotics can be hunted year-round.  Native animals can only be hunted when in season.  Exotic hunts range in price from $500 to $10,000+, depending a trophy quality and species. See ranch for details.

27. What are the check-in and check-out dates and times?

Our check-In time is 3 pm on day of arrival. Please don't arrive early, as the gates are locked until then. It is important that you are on-time, as the group orientation cannot start until all hunters are present. Check-out is no later than 1 PM on the third day. (46 hours after check-in)  

 

28. What if I want to bring an extra hunter?

Extra hunters can be brought when booked in advance. Please call the ranch for details..

29. What if I want to bring a non-hunting guest?

Non-hunting guests can be brought for a cost of $250, which will cover their meals and lodging for a 3 day hunt. Non-hunting guests must be booked in advance.

30. About Gratuity

If the staff provides you service that exceeds your expectations, please feel free to show your added appreciation at or near the end of your stay with us.  Your staff is on duty 12 hours per day and they strive at all times to insure you have the best trip possible while providing attentive service. Accordingly, your gratuity will be appreciated. The customary and recommended gratuity for a 3 day hog hunt is a minimum of $50 per hunter.  This will be divided among all staff members.  For exotic hunts, the customary gratuity is 15-20% of the hunt cost.

31. How are the hunts conducted?

Typically, the hunts are spot and stalk during the daylight hours, and blind hunting during the dark hours. Upon request and for special needs, the daytime hunts can also be done from blinds.

32. Is this hunt recommended for younger hunters?

With parental guidance, this is a great hunt for younger hunters.

33. coming soon

34. If I have physical restrictions, can I take this hunt?

Depending on the severity of the physical restriction, most of our hunts are still possible.

35. If I wish to extend my stay beyond the hunt,

what is there to see and do?

 

San Antonio and Gonzales are very historic, and if you are interested, you can be given many recommendations of things to see and do on your extended stay.

36. How long do I have to book the hunt once it is purchased?

Unless otherwise specified, you have up to two years to redeem your hunt, based on availability.

37. What are the lodging facilities?

All hunters will be provided a bunk in the bunkhouse at the lodge on the ranch. If you prefer more privacy, you may upgrade to a private room or a cabin.  Click here to reserve a private room or cabin:  http://texas-hog-hunts.myshopify.com/products/private-cabin

38. Do I need to bring a cooler?

If you are driving, please bring your coolers, however if you are flying, coolers can be bought at the local Wal-Mart.

39. Are meals provided?

Meals are provided by the ranch staff at no extra cost. The exact menu can vary, but usually includes five (5) meals during your hunt. The meals consists of two (2) dinners of different meats, sides, and non-alcoholic drinks.  Lunches vary from cold cut sandwiches, chicken sandwiches, burgers, etc,  chips and a drink. We offer typically two (2) breakfasts, consisting of traditional eggs, gravy, biscuits, and meat, etc. Sometimes, a different hot breakfast is served, such as Mexican tacos or breakfast burritos.   See the lodge: 

40. Coming Soon.

41. Is there a place to sight in my gun once I arrive?

Yes.

42. Can we hunt at night?

The night hunt is non-guided and optional at no extra cost.You will need to bring a battery-operated flashlight with an amber or red lens.  Cell phones are highly recommended for communication with camp for animal pick-up.

43. Coming soon

44. Is an insect repellent needed?

You will need mosquito spray except in December-February.

45. Coming Soon

46. Ranch policy changes

The ranch reserves the right to make periodic changes to the FAQ as needed. It is recommended that you review the FAQ one last time before attending your hunt.

47. What if I need to cancel or reschedule my hunt?

You can cancel your hunt, but will forfeit your payment if it is not rescheduled. There are no refunds for hunts not taken. You can reschedule your hunt with no penalty, as long as it is reset within 2 weeks of the original date. 30 days notice must be given to reset a hunt to avoid forfeit. Only upon approval of the ranch, will an exception to this guideline be allowed for late cancellations. Upon approval, you will be allowed to reset your hunt, with a $50 per person rebooking fee. Trip Insurance can be purchased byclicking here.

48. What will the weather be like during my hunt?

www.weatherchannel.com

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PLEASE PRINT THE RELEASE FOR EACH HUNTER, SIGN, AND PRESENT TO THE GUARD AT THE RANCH PRIOR TO ENTRY:

 

_____________________________________________________________________________________________

 

PERMANENT LIABILITY RELEASE OF HUNTING TEXAS HOGS, MAIN LODGE RANCH, OR CANDELARIA RANCH, LLC AND ALL D/B/A of SAID RANCHES.

 

ASSUMPTION OF ALL RISK AND INDEMNITY AGREEMENT

 

Agreement / Waiver / Release of Liability and Full Assumption of Liability Contract HUNTING AND/OR OTHER SHOOTING ACTIVITIES INVOLVING FIREARMS ARE INHERENTLY DANGEROUS ACTIVITIES IN WHICH THE USE OF FIREARMS IN CLOSE RANGE OF OTHERS SOMETIMES OCCURS. THIS PROPERTY MAY HAVE HIDDEN OBSTRUCTIONS, THORNS, POISIONOUS SNAKES, OR OTHER NATURAL OR MANMADE OBJECTS WHICH MAY BE DANGEROUS TO HUNTERS AND/OR THEIR VEHICLES OR OTHER PERSONAL PROPERTY.
HUNTERS MUST LOOK OUT FOR THEIR OWN SAFETY FROM OTHERS BEARING FIREARMS ON THESE PREMISES AS WELL AS PHYSICAL CONDITIONS WHICH MAY EXIST ON THESE PREMISES. HUNTER / PARENT / GUARDIAN HEREBY ACKNOWLEDGES THEY ARE VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF THE DANGER INVOLVED AND HEREBY AGREE TO ACCEPT ANY AND ALL RISKS OF INJURY OR DEATH, PROPERTY LOSS OR DAMAGE.

HUNTER’S RELEASE/WAIVER OF LIABILTY and INDEMNITY

 

As a part of the lawful consideration for being permitted to hunt or trespass on any lands owned, managed or leased by the aforementioned ranches, or any other property owners on whose land I am allowed to hunt on, to participate in hunting and/or any other activity including but not limited to shooting activities and use of the facilities. I hereby agree to the following:
I am aware that hunting with firearms/archery, fishing, swimming, partying, alcohol consumption, working, operating of all terrain vehicles, and all other vehicles/equipment and related ranch activities and activities involving firearms and water (collectively referred to as the “Ranch Activities”) are dangerous . I hereby acknowledge that I have voluntarily chosen to participate in Ranch Activities with persons I may or may not know. I understand the danger(s) involved and hereby agree to accept any and all risk of injury, death, property loss or damage. I, the undersigned, do hereby unconditionally RELEASE, DISCHARGE AND AGREE NOT TO ASSERT A CLAIM AGAINST all Releasees, their officers, owners, agents, individuals, heirs, directors, family members, partners,employees, guests, attorneys, insurers, host(s) and the property owners on whose land I am allowed to hunt on, (collectively referred to as “Releasees”) from all claims, demands, and/or causes of action, that I , my heirs, my family members, distributees, guardians, legal representatives, successors or assigns now have, or may in the future have, for any injury (including without limitation, personal injury or death to my person and/or my children) or property damage or property loss resulting from the Ranch Activities, regardless of whether such injuries or damages result from the negligence in whole or in part, or other acts, of myself,Releasees, and/or any other person(s) engaging in the Ranch Activities. I further agree, that in the event any suit or claim is instituted against Releasees arising in any way from my negligence, the negligence of my guest, or my children, my agents, my employees or any other persons using the facility with or without my permission; I agree to INDEMNIFY AND HOLD HARMLESS Releasees from all liability in connection therewith including, but not limited to, their attorney’s fees and costs involved in connection with the defense of any such action. I further agree to assume any and all liability (including all attorney’s fees and hospital and medical expenses) incurred for any and all claims which arise during or result from my visit or occupation of any ranch properties or and or participation in Ranch Activities. I hereby agree to assume any and all liability for and to INDEMNIFY AND HOLD HARMLESS the Releasees for any claims which were caused in whole or in part by their own negligence or their gross negligence. I further expressly agree to assume all of the related expenses (including all attorney’s fees and hospital and medical expenses) arising from Releasees negligence or negligence as it relates to any claim and/or actions that arise during, or result from, my use or occupation of theReleasees properties and or participation in Ranch Activities. I hereby assume full responsibility INDEMNIFY AND HOLD HARMLESS Releasees from any loss, liability, bodily injury, property damage or loss, or cost, (including all attorney’s fees and hospital and medical expenses) incurred by any Releasee arising out of my, my family members, my minors or my guests participation in Ranch Activities.

 

I UNDERSTAND THE RELEASE AND INDEMNITY STATED IN THIS AGREEMENT ARE SPECIFICALLY INTENDED TO BE APPLICABLE EVEN IT IS ALLEGED OR PROVED THAT ALL OR SOME OF THE DAMAGES INCURRED WERE CAUSED AS A WHOLE OR IN PART BY ANY ACT, OMISSION, NEGLIGENCE, GROSS NEGLIGENCE, OR ANY OTHER CONDUCT WHATSOEVER OF ANY OF THE RELEASEES.

 

I hereby attest that I will abide by all Federal, State, County or any Ranch laws and/or rules and regulations set out for the hunting and taking of game. In addition, I understand that I am responsible for all my actions and anyReleasees Ranch is not responsible for my actions, the actions of others or for the theft or loss of any kind.
I hereby attest that I have read the frequently asked questions page (FAQ PAGE) on the website and have understood and agree to the terms therein.

 

 CAUTION: READ BEFORE SIGNING

 

I have carefully read this Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement, fully understand its contents. I understand that I have given up substantial rights by signing it, am aware of its legal consequences. I am aware that this is a release of liability and a contract between myself and the releasees and have signed it freely and voluntarily, without inducement, assurance or guarantee being made to me and intend my signature to be a complete and unconditional legal release of all liability to the greatest extent allowed by law. I further agree that this is a permanent liability release waiver and discharge of me, my heirs, my family members, distributees, guardians, legal representatives, successors or assigns, and indemnity agreement. It shall be considered a continuing release and indemnity agreement, effective for current and all future visits to anyReleasees Ranch, properties and leases.

 

Executed this the __________ day of ______________, 20__ Print Name ________________________________ Signature __________________________________ Address______________________________ City _____________________ State ________

 

 

 

 

 

 

 

 

 

 

 

 

 Parents with Minors
As a parent, guardian or custodian, I am signing this document on behalf of my minor child and agree to be specifically bound to all the terms and conditions of this Agreement. I have read the agreement, fully understand the terms herein, understand that I have given up substantial rights by signing it, am aware of its legal consequences, and have signed this document freely and voluntarily without any inducement, assurance or guarantee being made to me. I intend my signature to be a complete and unconditional release of any and all liability to the greatest extent allowed by law and further agree to indemnify and save and hold harmlessReleasees.
Print Name(s) of Minor(s) below:

1. ________________________________________

2. ________________________________________

3. ________________________________________

4. ________________________________________

5. ________________________________________
___________________________________________________________

 (Print Name of Parent, Guardian or Custodian of Minor)
Address ________________________________________ City ________________________ State ______________

________________________________________________________ Date: ________, 20____ (Signature of Parent, Guardian, or Custodian of Minor)

 

 

 

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