Kid Fishing Derby Registration Form

Kids' Fishing Derby Registration Form

One child per form
Date of Fishing Derby:

Saturday, March 7, 2026

Check-in Time: 7 AM

Derby fishing is from 7:30 AM until 10 AM

Weigh-in and Lunch: 10 AM

Award Ceremony: 11 AM

Location of Fishing Derby:

Javors Lucas Lake Public Fishing Area.

150 Broach Lane, Macon, GA 31211, off Upper River Road in Jones County

Ages 3-16 as of March 7, 2026

Brackets:

3-5 years old

6-9 years old

10-13 years old

14-16 years old

Public Fishing from 1 PM until 5 PM
PARTICIPANT'S FULL NAME*

First NameLast Name
Participant Age*
As of March 7, 2026
Age Bracket*
As of March 7, 2026
PARTICIPANT'S MEDICAL HISTORY
IF THEY HAVE NO MEDICAL HISTORY PLEASE PUT N/A
Have you fished previously?
Number in Party
Parent/Guardian's full name*

First NameLast Name
Parent/Guardian's Cell Phone*
Please enter a valid phone number.
Parent/Guardian's email address*
example@example.com
Second Parent/Guardian's full name

First NameLast Name
Second Parent/Guardian's Cell Phone
Please enter a valid phone number.
Second Parent/Guardian's email address
example@example.com
Are you interested in volunteering
Are you interested in Sponsoring?

Kids’ Fishing Derby Rules
1. No Adults fishing until after the event.
2. All participants must register and check in at the check-in table upon arrival.
3. No fishing from the dam.
4. No fishing prior to 7:30 am.
5. No cleaning fish on site.
6. No more than 2 poles per child.
7. No live game fish shall be used for bait.
8. No wading or boats.
9. All participants must have their own gear. Fishing poles and bait will not be provided on site.
10. All MWA and Javors Lucas Lake rules must be followed.

WAIVER OF LIABILITY AND

ASSUMPTION OF RISK AGREEMENT

This Waiver of Liability and Assumption of Risk Agreement is entered into by the undersigned visitor and Macon Water Authority (MWA), its officers, employees, agents, contractors, affiliates, and representatives.

Assumption of Risk: Visitor acknowledges and understands that visiting MWA’s facilities and/or job sites involves inherent risks, including, but not limited to, injury or death from construction activities, heavy machinery, hazardous materials, and other site-specific dangers. The visitor voluntarily assumes all such risks.

Waiver of Liability: To the fullest extent permitted by law, the visitor waives, releases, and discharges MWA, its officers, employees, agents, contractors, and affiliates from any claims or liabilities arising from injuries, losses, or damages sustained while on Company premises or job sites, regardless of cause, including company negligence.

Indemnification: Visitor agrees to indemnify and hold harmless MWA from any claims, damages, or expenses arising from the visitor’s presence on MWA premises or job sites, including claims from third parties.

Health and Safety: Compliance Visitor agrees to comply with all safety rules and guidelines while on MWA premises or job sites and acknowledges that failure to do so may increase the risk of injury.

No Admission of Liability: This Agreement does not admit liability by MWA for any injury or damage sustained by the visitor. It is a waiver of potential claims.
Severability: If any provision of this agreement is found to be invalid, the remaining provisions will remain in full effect.

Governing Law: This Agreement is governed by the laws of the State of Georgia.

By signing below, the visitor acknowledges and agrees to the terms of this agreement.
I acknowledge that I read the Disclaimer and rules*

Clear
Signature
Date Signed*

MonthDayYear
Date
Should be Empty:

Kids' Fishing Derby Registration Form