Chautauqua Lake Bassmasters

PO Box 575

Celeron, NY 14720
 

Official 2010 Fall Open Team Entry Form

October 10, 2010 

Complete the Entrant information below, sign and return this Official Tournament Entry Form

with full payment ($200.00 PER TEAM, includes Big Bass pot), to the above address.
Your take off # will be determined in the order of completed entry forms received.
Boaters Name:  Are You More than 18 Years Old? YN
Address:
City:   State: Zip:
Phone:
Boaters Signature: ______________________________________  Date:___________
 
Non-Boaters Name: Are You More than 18 Years Old? YN
Address:
City: State: Zip:
Phone:
Non-Boater Signature:
 ______________________________________  Date:___________
Boat Information Make/Length/H.P.:

    By the Entrants signatures above, entrants declare that they are familiar with the tournament rules and that they will abide by them.  The Entrants signatures above also release the Chautauqua Lake Bassmasters, it’s Officers, Members, Agents, Employees, the Sponsors, Tournament Officials and other Contestants from all claims and liabilities for injuries, death and /or damages from the entrant or entrants family members that may be sustained by reason of participating in, or in conjunction with the tournament.  Parent or legal guardian must also sign for entrant less than eighteen (18) years old.

For additional information:
Tournament Director Matt Fish
716.763.9735 or via cell phone 716.640.9577