Derby Information Form

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Your Name *

First

Last

Email *

Phone

Name of Your Event, Derby, Contest, or Tournament *

Parent Organization?

If you are a Non-Profit, your Tax ID number

Event Start Date / Time *

Date

Time

Event End Date / Time *

Date

Time

Event Website if Applicable For Rules

Upload Your Derby Logo Here (JPEG, PNG)

Drag & Drop Files, Choose Files to Upload

Ticket Types (check all that apply) *

If eTickets (On-line) is Selected, Ticket Fees (10% of Ticket Price) *

Ticket Categories (check all that apply) *

Quantity of Each Ticket Category *

If "Youth" is selected above, please provide age cutoff

If "Discounted" is selected above, please provide discount amount

If "Early Bird" ticket is selected above, please provide ticket price and Dates for the ticket

If "Team" is selected above, please provide minimum & maximun anglers per team

If "Other" is selected above, please provide details

Price of Tickets *

Date/Time to Start Selling Tickets *

Date

Time

Date/Time to Stop Selling Tickets *

Date

Time

What timezone is the Event, Derby in? *

Location of Weigh-In Station(s) *

Minimum fish weight, if needed? (This will apply to all fish weighed)

Any Other Details We Should Know About? (Any side contests, Participant required forms, etc.)

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