Berryessa Clear Lake                            Tournament Date:  _____________

Boater: (Please print)

Name: ____________________________ SS#_____________________

Address: ___________________________________________________

City: ________________________State_____ Zip code_____________

Phone (____) _______________________e-mail____________________

Non Boater:

Name: ____________________________ SS#_____________________

Address: ___________________________________________________

City: ________________________State_____ Zip code_____________

Phone (____) _______________________e-mail____________________

"all in is $300" as itemized below

Mandatory	Options 100% payback
Entry      $160 Insurance       $10 Event Fee           $5 Membership         $35 one time fee  Additional family $20 one time fee	*Top Gun (winner takes all)    $30 *Red, White, Blue (winner each flight)  $20 *Big Bass (pays top 3 big bass)   $30 *Mystery Weight (must be present to win) $15 *Top 5 (pays top 5 in option)    $30 *must be in option to win option money

Total Due $________________ Cash________Check #___________

I/we have completed this application and have submitted the total fees for participation in consideration for the privilege of participating in this tournament. I hereby release all tournament officials and sponsoring organizations from all claims of injury and/or damages incurred in connection with this event. I understand that I must carry my own personal insurance for my boat and the anglers in it.  I understand that I may be subject to a polygraph exam and that National Bass West, Inc. reserves that right to refuse entry and services to anyone. Tournament Director’s decision is final. By signing this I do acknowledge to having adequate boat insurance. Please see the rules for further information.   Please sign below for release.

__________________________   ________________________
Boater                                             Non-boater