Crackerboys Bass Club
100% Payback Florida Bass Trail
Integrity is Everything!

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Application (print or download this form and bring to first Tournament)

 

ANGLER 1

NAME: ____________________________________________________________________

ADDRESS: _________________________________________________________________

CITY: ___________________________________ ZIP: ________________________

PHONES: HOME: _______________________ WORK: ____________________

CELL: _______________________ FAX: ______________________

SIGNATURE: ______________________________________________________

 ANGLER 2

NAME: ____________________________________________________________________

ADDRESS: _________________________________________________________________

CITY: ___________________________________ ZIP: ________________________

PHONES: HOME: _______________________ WORK: ____________________

CELL: _______________________ FAX: ______________________

 SIGNATURE: __________________________________________________

 ALTERNATE

NAME: ____________________________________________________________________

ADDRESS: _________________________________________________________________

CITY: ___________________________________ ZIP: ________________________

PHONES: HOME: _______________________ WORK: ____________________

CELL: _______________________ FAX: ______________________

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)

100% PAYBACK FLORIDA BASS TRAIL

 

SEND ENTRY FORM AND FEES MADE OUT TO:

CRACKERBOY"S BASS CLUB 8302 N. 40TH STREET TAMPA, FLORIDA 33604

 


     

 

Please send membership Applications or Entry Fees To:

 

Cracker Boys Club

8302 N. 40th St.

Tampa, Fl 33604

FOR MORE INFORMATION CONTACT:   LONNIE CROCKER  PH# 813-985-1779 OR 813-927-0737