Hooked On Fishing, Not On Drugs

Fishing Derby Registration

This form is for pre- registration purposes in order to reduce the wait in line the day of the Fishing Derby, June 23, 2012 check-in starting at 8 a.m. held at the Craig and Georgia Abbott property. If you plan on permitting your child to participate, please complete this form in full and click the "Register Now" button. All participants must be 17 years of age or under and accompanied by a parent or legal guardian. All fields are required. The information you provide is not distributed to anyone, and is used only for the purpose of the fishing derby pre-registration.
Fields marked with an asterisk (*) are required
 
   
     

In consideration of permission granted to my child by the Police Department of the City of Iola, County of Allen, State of Kansas, to participate in the Hooked on Fishing Not on Drugs Fishing Derby, June 23, 2012, I hereby release the City of Iola, its agents, employees, helpers of the fishing derby, and the Craig and Georgia Abbott family, or members of, from all actions, causes of action, damages, claims or demands which I, my heirs, executors, administrators or assigns may have against the City of Iola, and other above described parties, for all personal injuries known or unknown which the below named children has or may incur by participating in the above described activity.

I, the undersigned, have read this release and understand all its terms, and I execute it voluntarily and with full knowledge of its significance.