Kids Fishing Derby - June 16, 2007 at Prospect Lake

Official Kids Fishing Derby Registration Form
As parent or guardian of the below named child, I certify that said child has my permission to attend and participate in the above mentioned Kids Fishing Derby, held on the above date, time and location. In signing this form, I hereby waive and release all other participants, the host, sponsors, and all other officials or parties involved in the Derby from all claims and/or damage in connection with this Kids Fishing Derby. I also hereby grant the sponsor and co-sponsor the unconditional right to use the name, voice and photographic likeness of the child in connection with any of their audio/video productions, articles, or press releases, but not as an endorsement.

Signature will be collected at check in.