This form authorizes________________________________to hunt Elk and/or Mule Deer within the boundries of golden Derrick, Gradys, Lilly of the valley and/or Monument Ranches located NW of Meeker, CO from a Period of ___________20___ to ____________20___.

The above-named person may also hunt the adjacent BLM land and agrees to obey all of the State of Colorado fishing and hunting regulations, including the possession of proper hunting licenses and Hunter safety Certificate for persons born after the year of 1949 and agrees to follow all of the hunting safety and ethics procedures so as not to cause harm or bodily injury while hunting to himself/herself or to the other hunters in the vicinity.

The above-named person agrees to accept full responsibility for illegal trespass to a neighboring property and the monetary burden it may carry.
Exception: Wounded game crossing over should be reported to us and after the permission is obtained from the neighboring owners to cross the fence, we will be responsible.

By signing below the above-named person agree to hold harmless the owners of the golden Derrick, Gradys, Lilly of the valley, Monument Ranches and/or Sage Brush Hunting Adventures, Inc. for ANY personal or property damages.