Fishing Derby Registration 2021

  • Parent Guardian Information

  • Child One

    Please fill in all information for each child.
  • Child Two

  • Child Three

  • Photo Release
    On behalf of my children, I do hereby give the Chesapeake Bay Environmental Center (CBEC) and its representatives the right to use my picture or photograph in all forms of media for advertising, trade, or any other lawful purpose. I waive the right to inspect and approve the finished product that may be created, to include, but not limited to, written copy, and/or image in print or on a website. I understand that the CBEC cannot control the unauthorized use by other persons once my image is published. Any claim I may have concerning unauthorized publication of my image must be pursued by me against the unauthorized user. CBEC disclaims any responsibility for such unauthorized use of my published image.
  • This field is for validation purposes and should be left unchanged.