ࡱ> oqn +bjbj 8H"XX8D84LlllllL L L L L L L$INP DL"DLXXllEYLUUUjX8llLULUUFXJl03"=.H( LoL0LVHRTRPJRJ(UDLDL6LR :  ________________________________________________________________________ Please print all information in blue or black ink. Name: __________________________________________________________________ Address: _________________________________________________________________ __________________________________________________________________ Phone: (_____) ______-_________ Hunter ED I.D. No: _________________________ (if born after December 31, 1968) Applicants must be mobility-impaired. Mobility-impaired is defined as a permanent physical condition that severely impairs mobility from either paralysis or amputation of one or both lower extremities, which requires assistance from a wheelchair, braces, crutches, or other similar aids. The applicants physician must verify they meet the mobility-impaired definition in the above statement by filling out and signing the required information below. _____________________________________________________________________________ Clinic Name and Address _____________________________________________________________________________ Physician Contact Number and Email Address ________________________________________ _________________________ Physician Signature Date Disclaimer: Assistance for activities of daily living (ADL) will not be provided. If help is needed, the applicant is required to provide their own personal assistant. I would like to have _________________________ (______) _______-_________ be my personal assistant. Personal Assistant Name Phone Number I agree to comply with all regulations, conditions and disclaimers as set forth in applying for and participating in this special hunt. I also agree to not hold the government or any organization, or person affiliated with this hunt liable for any damages or personal injury while participating in any portion of this event. ________________________________________ __________________________ (Signature) (Date) **Please Mail completed form to Dale Bumpers White River NWR P.O. Box 205, Saint Charles, AR 72140 Attention: Wesley Howard** Cooks Lake Deer Hunt for the Mobility Impaired December 7th 9th, 2018 A Recreational Opportunity for Permanent Mobility Impaired Individuals Purpose The Dale Bumpers White River National Wildlife Refuge Special Deer Hunt at Cooks Lake was developed to help manage the deer herd in this area through the provision of a recreational opportunity. This opportunity is being extended to a special group of the nation's population that has a permanent physical condition that severely impairs their mobility. These individuals are fully capable of properly using a firearm or archery equipment to hunt game, but have restricted ability to access land for a quality hunting experience. This hunt is an effort to provide access, facilities, and other needed resources so these individuals can enjoy a safe and successful recreational experience as most other individuals in our nation. Location and Description Located in Arkansas County along White River in east central Arkansas, Cooks Lake is about 3 miles east of the U.S. Post Office for Casscoe, AR at the intersection of AR Highways 33 and 33S, 14 miles east of Stuttgart via AR Highway 146 & 33. Both upland and bottomland hardwood forests are found, consisting primarily of oak, hickory, gum, pecan and cypress. Cooks Lake, Little Cooks Lake and a cypress and buttonbush filled reservoir are found on the site. During times of overflow from White River, most or all of the bottomland forest can be naturally flooded to depths of 10 feet or more. Background Cooks Lake refers to more than a body of water. The name refers to a unit of the Refuge that is managed by three partners in a truly symbiotic relationship. The U.S. Fish and Wildlife Service, Arkansas Game and Fish Commission, and the Arkansas Game and Fish Foundation comprise this triad of cooperation. The area has been set aside for use as an outdoor classroom by schools and youth groups. It is also used twice a year for the Refuges special hunt program. Cooks Lake can be described as having marvelous inherent properties. There is something wonderful about this place that you can sense without anyone having to tell you why it is special. Every fall we have the opportunity of taking five new friends on the hunt of a lifetime. Dozens of hopeful hunters will apply for this years mobility impaired hunts at Cooks Lake. We will randomly draw five names that meet the Refuges criteria of mobility impaired and notify the lucky winners. Those selected will be invited to stay at the lodge at Cooks Lake with all meals and lodging furnished for free. After breakfast each morning, hunters will be taken to their stands one at a time. Each hunter is carefully loaded into either a hydraulic lift stand or a ground blind of their choosing. Hunters have the choice to stay on the stand all day or to be picked up for lunch. This hunt has been described by past participants as the Hunt of a Lifetime because of the quality of hunting and hospitality from the staff. Point of Contact Dale Bumpers White River National Wildlife Refuge P.0. Box 205 St. Charles, AR 72140 Wesley Howard, Forester, Telephone: 870-282-8249 Method Type of hunting devices permitted on the hunt will be all weapons legal for deer hunting in the state of Arkansas. (i.e.-center fire, muzzleloaders, and archery) No dogs will be allowed in the hunt, nor allowed on the ground during the hunt. Bag Limit A total of two BONUS deer may be harvested during the three day hunt period. Only one buck may be harvested. Each hunter may hunt until a total of two deer (one buck, one doe) have been harvested. These BONUS deer DO NOT COUNT against state bag limits! Monitoring A check station will be located near the education facility to collect biological data and insure safety during the hunt. ALL deer must be checked immediately upon return from the field. Each hunter will be required to check in and out with the staff during each hunt session. This will help to ensure safety and accountability of all participants. Season The season will be a special deer hunt for the Mobility-Impaired in Zone 661. All hunters must check in by noon December 8th for a mandatory orientation. Hunters may hunt the afternoon of the 8th through noon December 10th. Permits Applicants for this hunt must hold a valid Arkansas deer hunting license. Applicants must be mobility-impaired individuals. Mobility-impaired is defined as a permanent physical condition that severely impairs their mobility from either paralysis or amputation of one or both lower extremities, which requires the assistance from a wheelchair, braces, crutches, or other similar aids of mobility. Applicants must have a physician verify they meet the mobility-impaired definition defined in the application. Applicants need to have their physician sign the application. Assistance for activities of daily living (ADL) needs will not be provided by staff. If help is needed, the applicant is required to provide his or her own personal assistant. Applicant Procedure and Permit Notification Five (5) permits will be issued by random drawing for this special hunt. Additional names will be drawn in case alternates are needed to fill in. Notification of successful applicants will be by telephone. A packet of instructions will be mailed to each successful applicant following the drawing. Hunters and their assistants will be required to remain in designated blinds during hunting hours. The assistant may leave the blind to retrieve a harvested deer, but only after two-way radio contact with staff. Portable radios are provided to each hunt party for direct communication with staff. The area is closed to all other hunting during this special hunt. Fishing is permitted with a valid state fishing license. A handicap ramp and pier are available. Hunter Orange All hunters and their assistants must wear hunter orange during the hunt. The colored area of the garment must total at least 400 square inches above the waist. In addition, a hunter orange head garment must be worn. Safety Briefing Before the hunt begins, the permitted hunter and their assistants will receive instructions and review of safety rules and regulations from refuge and/or AGFC staff. Lodging Lodging will be provided for participants and one (1) volunteer assistant per participant. If more than one assistant is required, lodging for that individual will most likely be available by adding a cot to the room.     Dale Bumpers White River National Wildlife Refuge Deer Hunt for the Mobility-impaired at Cooks Lake Dale Bumpers White River National Wildlife Refuge, P.O. Box 205, St. Charles, Arkansas 72140 KZ[! 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