SEND ENTRY FORM TO THE Regional Director for the tournament you wish to enter, check the team pages for addresses.

Lake                                                                     Date                                                                

Name ______________________________________S.S. # __________-________-________

Address______________________________________________________________________

City __________________________ ZIP _________ Phone (______)_____________________

Signature: X___________________________________________________________________________

Name _______________________________________S.S. # __________-________-________

Address______________________________________________________________________

City __________________________ ZIP _________ Phone (______)_____________________

Signature: X__________________________________________________________________________

Check with Regional Director for applicable fees and/or permits.  Some options not available in all regions.

Basic Entry

$120

  TOP 3 or 5 Option

$20

Big Bass Option

$20

 

Additional Option

$20

All American Option

$20

  WON BASS membership

$45

 
   In consideration of permitting me to compete, enter, observe or participate in any way in this event, I, personally and on behalf of my heirs, successors, servants, assigns, executors, administrators, guardians and conservators, hereby release, discharge, covenant not to sue, acquit and hold harmless Western Outdoors Publications, Inc., and its affiliates, subsidiaries, divisions, partners, employees, principals, agents, servants, heirs, administrators, successors, sponsors, shareholders, directors, officers, representatives, attorneys and assigns (collectively the "Publisher") and agree to hold them free and harmless from and against any and all claims, judgments, appeals, rights, demands, costs, expenses, liabilities, obligations, claims, actions and causes of actions of any character whatsoever, whether known or unknown, suspected or unsuspected, arising from their negligence or otherwise, including but not limited to, all liabilities for personal injury, property damage or wrongful death caused by such negligence or otherwise (the "Claims").

I also agree to indemnify and defend the Publisher against the Claims, and any other damages, costs and expenses, including reasonable attorney's fees, resulting from any claim made by me or my agents or successors in-interest. I understand and agree that under this provision, the Publisher will be indemnified by me whether the Publisher's potential liability for Claims has arisen as a result of the Publisher's negligence alone, or of co-negligence with me, or the negligence of others.

I have read this release and waiver of liability, assumption of risk and indemnity agreement, I fully understand its terms, understand that I have given up substantial rights by signing it, and have signed it free and voluntarily without any inducement, assurance, or guarantee being made to me and intend my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.
                                                   (Both members of the team must sign).