 |
District 5 Tournament Application
NOTE: TWO week cut-off policy applies for all District Tournaments.
Mail Applications To:
District 5 Tournament Director
Monte Misplay
236 Lippencott Rd.
Waynesburg, Pa. 15370
Home:724-627-0570
Cell:724-998-2864
Entry Fees:
District Tournaments - $40.00
July 8, Sat. Erie
Aug. 5, Sat. Yough
Sept. 9, Sat. Erie
Tournament Site_______________Sponsoring Dist.____Tour.Date________
Name__________________________Club_____________Club #_______
Address______________________________________________________
City___________________________State_______Zip Code______________
Home Phone_________________e-mail________________________(optional)
Indicate (Owner / Rider_________Make Of Boat____________________
PA Reg. #________________HP_______ HP Rating________________
If rider,can you bring a boat?Yes____(Fill out boat info above No____
If applying as an owner, do you carry the minimum $300,000 Liability Insurance on your boat? __________________(Yes/no)
Are you a member in good standing of the PA B.A.S.S Federation United? ________ (Yes/No)
Proof of insurance and PA Bass Federation membership must be provided immediately upon request of the Tournament Director. Failure to do so will result in forfeiture of any monies and or points awarded in the tournament.
Guaranteed partner Yes/No_____Partner’s name__________________
Send BOTH applications together.
Emergency Phone and Contact____________________________________
I have read, understand and agree to abide by all federation rules and state laws governing this tournament. I further agree to abide by any on-site ground rules deemed necessary by the tournament director. I further agree to waive the tournament officials from any liability resulting from careless, hazardous, or negligent operation or use of equipment by competitors. I also understand that my signature on this application verifies the information contained on this application to be accurate and correct.
Signature_______________________Date___________Fee Paid $______
!!Failure to completely fill all entries on this application will result in rejection of the application.!!
Greene County BassMasters
Send E-Mail to: dmriley@alltel.net
Copyright © 2006 District 5 Tournament Director. All Rights Reserved