AZ Derby Registration




"Hooking Onto Hope" Children's Fishing Derby

$10 First Child, $5 each additional per family
** Childhood cancer warriors and survivors fish FREE

 

 SCHEDULE OF EVENTS

10:00-11:00 AM

Children's Derby Registration

11:30 AM to 2:30 PM

“Hooking Onto Hope” Children's Fishing Derby

4:00 PM

Awards Ceremony





"Hooking Onto Hope" Derby Registration

Please fill in all information shown below, then click 'Submit'.


Parent/Guardian Information
Parent or Guardian Name: *
Street Address 1: *
Street Address 2:
City: *
Zip Code: * (5 digits)
State: *
Contact Information
Daytime Phone:
Evening Phone:
Email: *
Children's Derby Information
Is this your first Fishin' for the Cure Tournament?: *

Total # in Family Attending: *
Number of Children Fishing:
Do you have fishing poles? *
Children's Names and ages: *
Are you a patient or survivor family? *
Patient/Survivors name, age, cancer type and current status (NED, In Treatment, etc.) :
      * If Applicable
How did you hear about us?
Comments:


Mail in Registrations:
If you would rather mail in your registration please print out the following registration forms: