Mentee Application

Thank you for your interest in Kicking Bear’s mentorship program. Our mission is to “Put a bow in a kid’s hand and lead their family to the Lord-One on One”. Through mentorship, we accomplish the “one on one”.

Please note that we are limited to the amount of mentor/mentee pairs we can accomodate soley based on the number of qualified applicants. That being said, it may take some time after your application has been reviewed before signing a commitment with a mentor.

God Bless,

The Kicking Bear Team

Mentee (Child)*
First Last
Today's Date*
MM slash DD slash YYYY
Youth's Date of Birth*
MM slash DD slash YYYY
Age*
Parent/Legal Guardian*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
School Attending
Hunters Safety
- Yes
- No
Harvested Game
- Yes
- No
Type of Animal Harvested
Outdoor Experience
Hobbies and Interests
Firearm Experience
Hunting Experience
Any special situations needs and allergies etc.
Why you feel child would benefit from being mentored or attending an event
Would you have any concerns about signing a 1-year commitment with the mentor?
How did you hear about this opportunity?
Additional Comments/Concerns
Emergency Medical Release*
As the parent or legal guardian, I acknowledge that the above information is to be used in lieu of an Emergency Medical Release Form
Release of Liability and Assumption of Risk Agreement*
As the parent or legal guardian, I have read the Release of Liability and Assumption of Risk Agreement, and I fully understand its terms, and understand that I have given up legal rights by clicking and signing this form, and I do so freely and voluntarily without any inducement.
Photo/Video Release*
As parent or legal guardian, I have read the Photo/Video Release Form and understand that if I DO NOT wish to have my child's image used by Kicking Bear, it is my responsibility to notify Kicking Bear prior to the event via email at info@kickingbear.org.
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Mentee Application

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608-881-6458

info@kickingbear.org