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May 16th/September 12

for Vail Lake members AND non-members  Entry Form

Vail Lake
May 16th, September 12
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                            

 

Entry                      $300

Insurance               $10

 

 

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 reserves that right to refuse entry and services to anyone. Tournament director’s decision is final.  Please see the rules for further information.      Please sign below for release

_________________________                  ________________________
Boater                                                   Non-boater

 

May 16th/September 12

 

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

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