Membership Application
Please Print and Complete this form and Bring to one of the 1st two tournaments. (Jan or Feb.)
Crackerboys Application
ANGLER 1
NAME: ____________________________________________________________________
ADDRESS: _________________________________________________________________
CITY: ___________________________________ ZIP: ________________________
PHONES: HOME: _______________________ WORK: ____________________
CELL: _______________________ EMAIL: __________________________________________
SIGNATURE: ______________________________________________________
ANGLER 2
NAME: ____________________________________________________________________
ADDRESS: _________________________________________________________________
CITY: ___________________________________ ZIP: ________________________
PHONES: HOME: _______________________ WORK: ____________________
CELL: _______________________ EMAIL: __________________________________________
SIGNATURE: __________________________________________________
ALTERNATE
NAME: ____________________________________________________________________
ADDRESS: _________________________________________________________________
CITY: ___________________________________ ZIP: ________________________
PHONES: HOME: _______________________ WORK: ____________________
CELL: _______________________ EMAIL: __________________________________________
In signing this entry form, I/we hereby agree and acknowledge that, if I/we claim any prize payable by the bass tournament, I/we are subject to a requirement to submit to and pass a polygraph test. I/we understand that prize claimants shall be subjected randomly for polygraph testing at the sole discretion of the tournament director. I/we further understand and agree that my/our failure to pass such polygraph test shall cause my/our disqualification from eligibility to collect any prize payable by Cracker Boy’s Bass Club. In signing this entry form, I/we wave and release all sponsors, host and tournament officials from any and all claims of injury, theft or damage resulting from a Cracker Boy’s Club bass Tournament.
MEMBERSHIP WILL BE $15.00 PER PERSON, $30.00 PER TEAM / FIRST TOURNAMENT $110.00 INCLUDES MEMBERSHIP FEE
TOURNAMENTS THEREAFTER $80.00 ($60.00 TOURNAMENT + $20.00 BIG BASS)
SEND ENTRY FORM AND FEES MADE OUT TO: CRACKERBOY"S BASS CLUB 8302 N. 40TH STREET TAMPA, FLORIDA 33604