Poles and tackle provided to all Veterans Lunch Provided Support our Wounded Warriors! Come out and join us for our 3rd annual Rough River Lake Fishing with a Veteran Event.   Disabled Veterans spend the day fishing on us. Fisherman needed to volunteer their time and boats By Friday April 24, 2015 Event Date and Location Saturday, May 09 – Rough River State Park Marina Parking (270)257-2061 Registration Begins at 7:00am central time For further Information: U.S. Army Corps of Engineers Rough River Lake 14957 Falls of Rough Road Falls of Rough, KY 40119-6313 270-257-2061 www.lrl.usace.army.mil/Missions/CivilWorks/ Recreation/Lakes-RoughRiverLake CAPTAINS REGISTRATION FORM Captains Name: ________________________________________________________________ Address: _____________________________________________________________________ City: _______________________________ State: ___________________________ Zip:______________ Phone Number: (______)_______‐__________ Email:_________________________________ Gender: Male_______ Female_______ Number of Passengers I can take ___________ Vessel Make & Model:___________________________________________________________ Vessel Length: ___________ Width: __________ By signing below I am aware that I will be taking a disabled veteran of foreign wars fishing out on the lake by a boat that I will be operating. I understand that I will be working with persons that may have a number of disabilities being both physical and/or mental. I agree to wear a Personal Flotation Device (PFD) at all times and will also follow all Kentucky fishing and boat‐ ing regulations. Special Requests: _____________________________________________________________________________ _____________________________________________________________________________ Liability Release I ______________________________ hold the Friends of Rough River Lake and or any other participating agency harmless and free of any liabilities related to any and all accidents result‐ ing in damage to personal property or accidental injury, to me or any other member of my party, while participating in this Friends of Rough River Lake event. Signature: ____________________________________________ Date: ___________________ PLEASE MAIL COMPLETED FORM TO: USACE Rough River Lake PH: (270)257‐2061 ATTN: J.D. Tucker [email protected] 14957 Falls of Rough Road Falls of Rough, KY 40119