PREMIER BASS TEAM TRAIL 2008

 

ENTRY FORM

 

 

___ APRIL 5  C.J. STRIKE RESV. (BLACK SANDS  MTN. HOME ID)                           ____MAY 17 BROWNLEE RESV. (CAMBRIDGE, ID.-WOODHEAD) 

 

___ JUNE 14  OWYHE  RESV. (ADRIAN, ORE. INDIAN CREEK  RAMP)                    ____JULY 19  LAKE LOWELL (CALDWELL,ID – LOWER RAMP)

 

___ AUGUST 9 OWYHEE RESV.  (ADRIAN, ORE. INDIAN CREEK RAMP)

             

CHAMPIONSHIP     September 20 & 21, 2008 C.J. STRIKE  RESV. ( GRAND VIEW, IDA.)      BLACK SANDS RESORT

 

MEMBERSHIP PAID   YES/NO               TO: PLEASE MAKE CHECKS PAYABLE

                          ENTRY FEE                    $160.00                   PREMIER BASS

                                 $10 BIG FISH                            $________                      2020 ALDER ST

                                $25 OPTION                               $________                     CALDWELL, IDAHO 83605    

                                $50 OPTION                               $________                     (208) 454-6336 FAX/VOICE

                         $100  OPTION                                   $_______              LARRY RAGANIT -DIRECTOR

 

TOTAL ENCLOSED        $____________  THURSDAY PRIOR TO TOURNAMENT WILL BE LAST DAY FOR MAIL PICK UP FOR ENTRIES!   LATE FEE $10.00 IF NOT RECEIVED BY THURSDAY!

 

WE THE UNDERSIGNED HAVE COMPLETED THE APPLICATION, READ & UNDERSTOOD THE RULES & REGULATIONS, AND ENCLOSED OUR ENTRY FEE AND HEREBY WAIVE AND RELEASE PREMIER BASS, ITS HOST, SPONSORS, TOURNAMENT OFFICIALS AND OTHER PARTIES FROM ALL INJURY/DAMAGE INCURRED IN CONNECTION WITH THIS TOURNAMENT.  WE ALSO AGREE THAT TOURNAMENT SPONSORS AND HOST HAVE EXCLUSIVE RIGHTS TO TAKE PHOTO’S, VIDEO OR AUDIO RECORDINGS TO USE OR DISPOSE OF SUCH MATERIAL IN ANY LAWFUL MANNER.  FURTHER, I CERTIFY UPON MY SIGNATURE BELOW, I CARRY LIABILITY INSURANCE COVERAGE FOR PERSONAL AND DAMAGE THAT MIGHT OCCUR ON MY BEHALF.

MUST BE SIGNED

 

X___________________________________________DATE:______________BOATER

 

X___________________________________________DATE:_____________NON-BOATER

 

X___________________________________________DATE:_____________ALTERNATE

 

BOAT_________________MOTORMAKE________________________________

HORSEPOWER_______________

BOAT COAST GUARD NO:____________________________________________

INSURANCE CO._____________________________________________________

POLICY NO:_________________________________________________________

EFFECTIVE DATE:_________________EXPIRATION DATE_______________

 

MEMBERSHIP FEE $35.00  PER PERSON      (ONE TIME FEE)        

         

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