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Lake
Name_________________________________________________________ |
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PARTNER
1 |
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Name_________________________________________________________ |
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Address_______________________________________________________ |
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City/State/Zip___________________________________________________ |
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Phone________________________________________________________ |
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SSN__________________________________________________________ |
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Membership
Number_____________________________________________ |
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Signature______________________________________________________ |
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PARTNER
2 |
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Name_________________________________________________________ |
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Address_______________________________________________________ |
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City/State/Zip___________________________________________________ |
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Phone________________________________________________________ |
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SSN__________________________________________________________ |
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Membership
Number_____________________________________________ |
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Signature______________________________________________________ |
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I
hereby release Southern Crappie Association and all sponsors of this
tournament from any loss of property, bodily injury or loss of
life that may occur in this tournament.
I understand that any contestant may be asked to TAKE AND
PASS a poly-graph or similar test to qualify for the receipt of a
prize and in order to verify compliance with all tournament rules.
Only one test per claim will be given.
I release Southern Crappie Association and all sponsors
from any liability resulting from the decision of the examiner,
agree that the decision of the examiner is final, and agree to
abide by the decision of the examiner. |
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I have read and understand
the rules of the tournament and terms of this release. |
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INITIALS |
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MEMBER
ENTRY FEE |
$ |
($75.00) |
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MEMBERSHIP
FEE (Annual) |
$ |
($35.00 each) |
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BIG
FISH (Optional) |
$ |
($10.00) |
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LATE
FEE |
$ |
($10.00
within 6 days of event) |
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TOTAL |
$ |
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Please
remember that your entry must be postmarked at least |
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seven
(7) days prior to the event you wish to enter. |
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Signature_____________________________________________ |
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SCA
is a non-profit organization |
