By signing below, I am certifying that I meet the eligibility requirements for assistance and the information provided above is true and accurate to the best of my knowledge. Further, I have read and understand Fishing for the Fight’s Travel and Expense Policy, and agree to the terms, conditions and limitations contained therein. I also expressly represent that I am not receiving and have not received reimbursement for any expense submitted to Kickin’ Cancer from any other source, including but not limited to insurance or other charitable or religious organizations.