NAME: ______________________________
DATE: ____________________
ADDRESS:________________________________
CITY: __________________________ STATE: ____________ ZIP:________
HOME PHONE: ________________
CELL PHONE: _______________
BOAT-MAKE: _______________________________
LENGTH: _____________
HORSEPOWER: _____________________
ELECTRIC? YES / NO.
LIVEWELL OR AERATED COOLER MANDATORY.
NUMBER OF YEARS BASS FISHING: _______
EMAIL ADDRESS:__________________________________________
IN SIGNING THIS APPLICATION, I HEREBY WAIVE AND RELEASE ALL OTHER CLUB MEMBERS, OFFICERS AND SPONSORS FROM ALL CLAIMS OF LOSS, INJURY AND/OR DAMAGE INCURRED IN CONNECTION WITH TOPWATER BASSERS OR TOURNAMENTS HELD BY TOPWATER BASSERS. I FURTHER UNDERSTAND AND AGREE TO THE RULES AND BY-LAWS OF TOPWATER BASSERS.
SIGNATURE: _______________________________________________
COMPLETE APPLICATION IF INTERESTED AND BRING TO TOURNAMENT. OR APPLICATIONS SHOULD BE EMAILED TO EDDIE KASPERZAK
