2026 Pymatuning Lake Association Kids Free Fishing Derby

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Please pick up your wristband at the registration table on the day of the event (August 1 and 2, 2026).

Email *

Last Name* *

First Name *

First name of participating child

Age *

Address *

City *

State *

Zip Code *

Release of Liability/Photo Release *

As the parent/guardian of the above named child, I hereby certify that said child has my permission to attend and participate in the above-mentioned Pymatuning Lake Association Kids Free Fishing Derby. In signing this form, I hereby waive, release, and hold harmless all participants, host, sponsors, and all other officials including Pymatuning State Park (PA DCNR), Ohio Pymatuning State Park (ODNR) and PA Fish and Boat Commission from any liability. In addition, I agree to abide by the rules and regulations under the jurisdiction of each listed agency. I also hereby grant the sponsors and/or co-sponsors the unconditional right to use the name, voice, and photographic likeness of the above-named child in connection with any of their audio/video productions, articles, or press releases, but not as an endorsement.

CHECKING THIS BOX REPRESENTS YOUR ONLINE SIGNATURE.

Required

Parent/Guardian Full Name *

Parent/Guardian Phone Number *

A copy of your responses will be emailed to the address you provided.

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