APPLICATION INSTRUCTIONS
UPSTATE MOBILITY IMPAIRED DEER HUNTS – 2009
PIEDMONT PRIVATE AREAS

The South Carolina Department of Natural Resources is cooperating with a number of private individuals and groups to co-sponsor two Upstate Mobility Impaired Deer Hunts this year. The first hunt will be on October 23-24, 2009 and will be conducted at sites in Cherokee, Spartanburg and Union counties. The second hunt will be on October 30-31, 2009 and will be at sites in Laurens and Newberry counties. Applicants can apply for one or both hunts.
Co-sponsors include the Harry Hampton Memorial Wildlife Fund, Georgia Pacific Corporation, Carolina’s Fence Association, South Carolina Disabled Sportsmen, Paralyzed Veterans of America, Sprinkle Prosthetics, the Wounded Warrior Project, South Carolina Wildlife Law Enforcement Officers Association and DNR’s TAKE ONE MAKE ONE program.

There is no cost to apply for these special hunts and each hunter is allowed to bring one person to assist him or her if desired. Please indicate if you need a hunting license wavier for this hunt. All hunts will consist of a noon lunch on Friday and hunting on both Friday afternoon and Saturday mornings.
Successful applicants will be notified in early October of their assigned hunt sites and dates and will be provided directions to the location where the noon meal will be held. After lunch, hunters can then follow someone to their respective hunt sites. Lodging is available at a few of the hunt sites so please indicate if you need lodging. Please complete all information on the application and make sure to complete and return the liability wavier form with your application.

UPSTATE MOBILITY IMPAIRED DEER HUNTS – 2009
CHEROKEE, SPARTANBURG & UNION COUNTY HUNT
OCTOBER 23-24, 2009
LIST OF HOSTS
CHEROKEE COUNTY
Dr. Darwin Keller – Keller Property
Mr. Bruce Randolph – Badlands Hunt Club
Mr. Edward Hollingsworth – Hambright Farm
Mr. Dwayne Carroll – Carroll Property
Mr. Benji Peterson – Broken Arrow Hunt Club
Mr. Wayne Cooper – Arcon Land & Timber, LLC
SPARTANBURG COUNTY
Mr. Harold Campbell – Campbell Property
Mr. Lon Alexander – BD Properties
Dr. David Weir – Longbeard Timber Company
Dr. and Mrs. Don McClure – Cow Ford Land Company
Mr. Keith Comer, Jr. – Comer Farm, LLC
Mr. Lamar Fuller – Bull Run Hunt Club
Mr. George D. Johnson, Jr. – Wylie Fork Creek, LLC
Mr. Stewart Johnson – Jimmie’s Creek Farm
Dr. George Graham – Tri G Gun Club
Mr. Will Montgomery – Pine Valley Farm
Mr. Scott Young – Fourth Lane Hunt Club
Mr. John Hayes – Elroma Hunt Club
UNION COUNTY
Mr. Ron Roberts – Beulah Creek Hunt Club
Mr. Wayne Garner – U. S. Sportsmen’s Club
Mr. George D. Johnson, Jr. – Tyger Ranch
Mr. Donnie Loftis – Padgett’s Creek Reserve
Mr. Donnie Loftis – Rabbit Road Hunt Club
Mr. Terry Shockley – Trophy Buck Hunt Club
Mr. Steve Koskela – Laura Lyn Farm
Mr. Walter Oates – Triangle 113 Farm
Mr. Frank Sistare – Fairforest Timber Company
Mr. Edward Hollingsworth – U. S. Sportsmen’s Club
Mr. Bob Jeter – Chufa Ridge Farm, LLC
Mr. Bill Meeks – Hunt Timber Company
•
Additional hosts may be added prior to the hunt.
UPSTATE MOBILITY IMPAIRED DEER HUNTS – 2009
LAURENS & NEWBERRY COUNTY HUNT
OCTOBER 30-31, 2009
LIST OF HOSTS
LAURENS COUNTY
Dr. Wallace Boyd – Quaker Creek Farm
Mr. Wade Pitts – Pitts Place
Dr. Claude Woollen – Woollen Farm
Mr. Steve Frantz – Southern Timber Associates
Mr. Chris Grant – The Clinton House Plantation
Mr. Charles Blackmon – Blackmon Farm
Mr. Bryson Thomason – Fuller Gray Farm
Mr. Tim Howard – Sugar Flat Hunt Club
Mr. Tex Small – Sundowner Farm
Mr. Tom Hawkins – Hawk’s Nest Hunt Club
Mr. Jim Barnes – Riveroak Properties
Mr. James Pitts – LPW Hunt Club
Mr. Dave Schemm – Triple S Hunt Club
Dr. Derrick Wessinger – Hurricane Hunt Club
Mr. Steve Johnson – Johnson Farm
NEWBERRY COUNTY
Mr. Lee Walsh – Belfast Hunt Club
Mr. Otis Taylor – The Scott Place (TCA)
Mr. Cecil Duffie – Mudlick
Mr. Donnie Loftis – Loftis Hunt Club
Mr. Terry Cotney – Lester Estate
Mr. Paul Cape – Deer Run Hunt Club
Mr. Rusty Harter – Piedmont Conservation Club
Mr. Gary Stephens – Belfast WMA
•
Additional hosts may be added prior to the hunt.
UPSTATE MOBILITY IMPAIRED DEER HUNTS APPLICATION – 2009
PIEDMONT PRIVATE AREAS
CHEROKEE, SPARTANBURG & UNION AND LAURENS & NEWBERRY COUNTIES
These special hunts are for severely mobility impaired individuals only. The eligibility requirements are very specific and include those who are permanently confined to a wheelchair, permanently require some type of mechanical aid such as a walker, braces, etc. to assist them in walking or have had a single or double leg amputation. If you do not fully and completely meet one of these criteria, do not apply! Applicants can apply for one or both hunt dates. Hunt sites will be assigned by random selection. Answer all applicable questions and please print clearly.
Name ____________________________ Telephone No. __________________ Email ___________________
Address ______________________________________ City, State, Zip _______________________________
Describe Mobility Impairment In Detail ________________________________________________________
___________________________________________________________________________________________
Are You a Veteran? ___ Yes ___ No Is Your Mobility Impairment Service Related? ___ Yes ___ No
Check Each That Applies to Your Physical Capabilities and Mobility Impairment:
_____ Permanent Confinement to Wheelchair – How Long? ________________________________________
_____ Permanent Use of Mechanical Aid to Assist in Walking – List Type of Aid (s) ____________________
______________________________________________________________________________________
How Long Has This Aid Been Utilized On a Full-Time (Permanent) Basis? ______________________
___ Amputee (Check): ___ Right Leg ___ Left Leg ___ Both Legs Utilize Prosthesis? ___ Yes ___ No
List Any Special Needs For Assistance (Heavy Power Wheelchairs and etc.) __________________________
Where Did You Hunt Last Year? ____________________ Hunting License Wavier Needed? ___ Yes ___ No
Overnight Lodging Needed? ___ Yes ___ No Bringing Someone to Assist You? ___ Yes ___ No
Indicate First and Second Preference of Hunt Dates and Counties
___ Oct. 23-24 in Cherokee, Spartanburg & Union Cos. ___ Oct. 30-31 in Laurens & Newberry Cos.
Applications are available at the DNR website at www.dnr.sc.gov/hunting/mobilityhunt. Applications can
also be copied but make sure you complete and return the liability wavier form with your application. All applications must be received at the Union DNR office by 5:00 pm, Monday, September 21, 2009.
RETURN TO: SCDNR – MOBILITY IMPAIRED DEER HUNTS
124 WILDLIFE DRIVE
UNION, S. C. 29379
(864) 427–5140 or FAX (864) 427-8460
LIABILITY WAIVER FORM
I understand that there are risks and dangers inherent in participating in hunting activities. I also understand that in order to be allowed to participate, I must give up my rights to hold liable the State of South Carolina and its agency the South Carolina Department of Natural Resources and all cooperating hosts, sponsors and landowners who accommodate special DNR hunts for any injury or damage which I may suffer while participating in a Department of Natural Resources draw hunt.
Knowing this, and in consideration of being permitted to participate, I hereby voluntarily release the State of South Carolina and its agency the South Carolina Department of Natural Resources and cooperating hosts, sponsors and landowners from any liability resulting from or arising out of my participation in the draw hunt.
I understand and agree that I am releasing not only the entities set forth in the two paragraphs above, but also the officers, agents, and employees of those entities.
I understand and agree that this release will have the effect of releasing, discharging, waiving, and forever relinquishing any and all actions or causes of action that I may have or have had, whether past, present, or future, whether known or unknown, and whether anticipated or unanticipated by me, arising out of my participation. This release constitutes a complete release, discharge, and waiver of any and all actions or causes of action against the State of South Carolina and its agency the South Carolina Department of Natural Resources, and its officers, agents, or employees and cooperating hosts, sponsors and landowners.
I understand and agree that this release applies to personal injury, property damage, or wrongful death, which I may suffer, even if caused by the acts or omissions of others.
I understand and agree that by signing this release, I am assuming full responsibility for any and all risk of death or personal injury or property damage suffered by me while participating in the draw hunt.
I understand that and agree that this release will be binding on me, my spouse, my heirs, my personal representatives, my assigns, my children and guardian ad litem for said children.
I understand and agree that by signing this release, I am to release, indemnify and hold the State of South Carolina and its agency the South Carolina Department of Natural Resources, and its officers, agents, or employees and cooperating hosts, sponsors and landowners harmless from any and all liability or costs, including attorney fees, associated with or arising from my participation in the draw hunt.
Applicant Signature: ___________________________________ Date: ____________________ ______
Address: ________________________________________________________________________________
City: ________________________ State: ____________________ Zip Code: ________________________
Emergency Contact: __________________________ Telephone: __________________________________
Parent or Guardian Signature: ___________________________ Date: _________________________________ (If applicant is under age 16)