Lacey Family Fish-In Saturday, April 19, 2008

                          Official Registration Form   Mail to:  Lacey Parks, PP Box 3400, Lacey, WA 98509-3400

           Parent or Guardian ___________________________________________________________________
                            Please Print          First Name                                               Last Name

        Address  ________________________________________________        Home Phone______________________

        City____________________________________ Zip_____________         Work Phone______________________

       E-mail (optional)__________________________________________

       I wave and release all rights and claims that might be held against the C.A.S.T. for Kids Foundation, Washington State Bass Federation,
         Trout Unlimited, Federation of Fly Fishers, Puget Sound Anglers, Washington State Department of Fish & Wildlife, Washington State Parks
        & Recreation Commission, the City of Lacey, its hired or contracted producers, and any other person(s) for any injury or losses suffered
        because of my participation or my child's in this event offered through the Lacey Parks & Recreation Department.   I further understand
        that falsifying information on this form my disqualify me from any/all prizes and awards.  Permission is also granted to photograph my
        child(ren), and myself and for C.A.S.T. and WDFW, or their nominee, to use in conjunction with the promotion of the C.A.S.T. or WDFW
        Youth Sportfishing Program.  Permission is also granted to photograph my child(ren) and myself for C.A.S.T. and WDFW, or their nominee,
        to use in conjunction with the promotion of the C.A.S.T. or WDFW Youth Sportfishing Program



       Signature of parent/Guardian___________________________________________________________________________  Date___________________


                    Registration only - no fee required                                                            -            $5/Registered Child  Optional Fee
                                                                                                    Must be 5-14 yrs    -             includes ZEBCO rod/reel & y-shirt

         Child's  Name         First                             Last                         Date of Birth                        (Mark T-Shirt Size for Child)
                                                                                                                                             ys    ym    yl    AS   AM     AL    $5

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     ______________________________________________________________     ____________                   ___   ___   ___   ___   ___   ___   ___

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         Total enclosed $_______
       Make checks payable to : LACY PARKS

                         "NO REFUNDS"

                                                    
                                                                        City of Lacey Use Only

             Date____________   $__________    Check # _________  Cash________   Receipt # ________