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Portage County Sheriff's Office 2023 Fishing Derby Registration
Please complete this FREE registration form for your child(ren) who will attending PCSO's 2023 Fishing Derby on
Saturday, June 24, 2023 from 12PM-4PM at the Ravenna Moose Lodge.
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* Indicates required question
Parent/Guardian Full Name
*
Your answer
Email
*
Your answer
Parent/Guardian Contact Phone
*
Your answer
Zip Code
*
Your answer
Where did you hear about the fishing derby?
*
Choose
Facebook
Instagram
Family/Friends
PCSO Staff Member
Other
How Many Children Are You Registering (Open to Children 16 and Younger)
*
Choose
1
2
3
4
5+
Child 1 Name
*
Your answer
Child 2 Name (Optional)
Your answer
Child 3 Name (Optional)
Your answer
Child 4 Name (Optional)
Your answer
Child 5 Name (Optional)
Your answer
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