Duck Derby Order Form 2026

2026 Duck Derby- Buy A Duck!

Win prizes up to $1,000 in cash! Fill out this form to secure your ducks for the 2026 Duck Derby! Make sure to tune in LIVE to our Facebook page at 1PM on Saturday, July 11th!

Contact Information

Name(Required)

First Last

Phone(Required)

Email(Required)

(A confirmation will be sent to the above email)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Buy a Duck

One Duck

Price: $5.00

Quack Pack (includes 6 ducks)

Price: $25.00

Total

Payment

Credit Card

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Comments

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We could not be more pleased with the care and support of the staff.

My daughter is lovingly cared for by staff who are always helpful.

My son is always happy to go to BARC and is joyful!

My son can’t wait to get there; we love all the people who work. We appreciate the outstanding efforts made by the staff every day.

I absolutely love BARC, my job, my coworkers, and of course the individuals! I believe in the agency and its mission. BARC is the best agency I have ever had the privilege to work for.

I am very pleased with the program; staff are very professional and courteous. They are knowledgeable and answer all questions extremely well.