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Diamond Valley Entry Form
Diamon Valley Region -LAKE PERRIS
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 $160 *Top Gun (winner takes all) $20
Insurance $10 *Red, White, Blue (winner each flight) $20
**Special lake fee  $5 *Big Bass (pays top 3 big bass) $30
(**extra $ will be pd back to anglers)         *Top 5 (pays top 5 in option) $30
Lake Fee $16 *must be in option to win option money  
($8 per vehicle / $8 per boat)    
Membership $35    
Additional family $20    

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. Please see the rules for further information. Please sign below for release

_________________________                  ________________________
Boater                                                   Non-boater

 

 

Diamond Valley Entry Form