Sponsored by The Fish Sniffer

Trout Derby, Shasta Lake

Entry Form

17th Annual
October 14-15, 2017

Sponsored by Shasta Lake Business Owners Association
 


The $150.00 (per angler) entry fee includes the cost of the derby, dinner on Saturday night. $250.00 large fish for Saturday and Sunday. Hosted by the Lakehead Lions Club. No host bar and dinner 6:00 p.m.

 
#1 Angler's Name (Team Captain) ______________________________________
Address ______________________________________
City ______________________________________
State & Zip ______________________________________
Phone ______________________________________
Dinner Choice Please circle one:     Steak         Chicken

 
#2 Angler's Name

 
______________________________________

Address ______________________________________
City ______________________________________
State & Zip ______________________________________
Phone ______________________________________
Dinner Choice Please circle one:     Steak         Chicken

 

I/we have completed the entry form and have submitted the total fee for participation (Lodging not included).

I/we hereby release all derby officials and sponsors from all claims of injury and/or damages incurred in connection with this event, I/we agree to abide by the derby rules and the judges decision. My/our signature on this entry form signifies that I/we read and agree with the rules of the event.

Angler #1 ______________________  Date:___________
Angler #2 ______________________  Date:___________

Print this form and return with check to:
Shasta Lake Trout Derby
C/O Sugarloaf Cottages Resort
P.O. Box 768
Lakehead, CA 96051

 

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