Chautauqua Lake Bassmasters
PO Box 575
Celeron,N.Y. 14720
Official Tournament Entry Form 2012

May 12th Crappie Tournament Lakewood Launch (6am-1pm) $70 per team

June 17th Chautauqua Lake Club Memorial - Prendergast Launch (6am-2pm) $100 per team
August 19th Chautauqua Lake – Prendergast Launch (6am-2pm) $100 per team
October 21st Chautauqua Lake – Long Point State Park Launch (7:00am-3:30pm)    $100 per team

Check the appropriate line above, complete the Entrant information below, sign and return this Official Tournament Entry Form with full payment which includes Big Bass pot, to the above address.  There is no late fee, but if you sign up at the launch, you will be one of the last boats out.

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 Donnie Stasczyk
 via cell phone 716-491-2131