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Southwest Entry Form
           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____________________

Mandatory
Options with 100% payback
Entry ($150 at tournament and $10 for fishoff) $160 *Top Gun (winner takes all) $50
Insurance $10 *Mystery weight (closest weight to random weight picked during draw)  $10
 Parking truck $11  *Red, White, Blue (winner each flight) $20
 Parking boat $13 *Big Bass (pays top 3 big bass) $30
yearly Membership $35 *Top 5 (pays top 5 in option) $30
Additional family $20 *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 may be subject to a polygraph exam and that National Bass West reserves that right to refuse entry and services to anyone. I understand that I must carry my own personal insurance for my boat and my non-boater.  The tournament director's decision is final.  Please see the rules for further information. Please sign below for release

_________________________      T-            ________________________
Boater                                     B-           Non-boater

Southwest Entry Form

 

National Bass West, Inc.
Phone: 760-497-8238
P.O. Box 1151
Valley Center, Ca. 92082 USA

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