Arc in the Park Registration — The Arc Northeast Mississippi

Plan fishing support

Fishing participant registration

Please complete one form for each person with a disability who plans to fish. Enter “None” where no help or accessibility support is needed.

Contact informationWho should we contact if event details or support plans change?

Parent, guardian, or contact name

Total number attending

Email address

Phone number

Person who will be fishingUse a general disability description only. Do not include medical record numbers or detailed medical history.

Name of person fishing

Age

Type of disability

Help needed

Accessibility requirements

Fishing supplies and volunteer support

Select everything Hope Outdoors should plan to provide.

Volunteer assistanceA volunteer to help during fishing Fishing poleA pole will be needed at the event BaitBait will be needed at the event

Additional information (optional)

Support planning acknowledgement I understand that the information above may be shared with Hope Outdoors and assigned event volunteers only to plan fishing assistance, poles, bait, and accessibility support. Photography notice I understand that photographs and video will be taken during this event. I will speak with event staff when I arrive if I have a photography concern.

Security check Enter the six-character code to help us block automated registrations.

Enter the code shown

This information is collected only to manage the event, plan requested support, and contact you if event details change.

The Arc in the Park & Fishing Fun

Fishing participant registration