14th Annual Pawhuska Trout DerbyPlease print, complete and mail this registration form to:
Prairie Trout Club, 114 E Main St., Pawhuska, OK 74056, (918) 557-6205 or 918-287-3553
Name:_________________________________________________________ Age:_____________ Shirt Size:_________
Address:_______________________________________________________ Email:______________________________
City:__________________________________________________________ State:_________________ Zip:__________
Fishing License Number:_________________________________________________
Signature:____________________________________________________________