Entry Form

Captain’s Name: ____________________________________________
Mailing Address: ____________________________________________ 
Town/City: ____________________________ Province: ____________
Postal Code: ___________________ Phone: ______________________ 
Email: ________________________________________                      
                                                                                               
Partner’s Name: _____________________________________________
Mailing Address: ____________________________________________
Town/City: ____________________________ Province: ____________
Postal Code: ___________________ Phone: ______________________
Email: ________________________________________
 

Please Check which day(s) you are participating in. Saturday Tournament Only _____ ($75.00) Sunday Tournament Only _____ ($75.00) Two Day Tournament _____ ($225.00)

Waiver of Claim Release and Indemnification agreement in consideration of the acceptance of my entry in the Shebandowan Fall Bass Classic, it’s promoters, employees, sponsors, organizers, host, directors, officers, and all other organizers and affiliated organization, agencies and/or agents and assignees and any other person assisting in this event from any claims for damages or injuries suffered by me as a result of my participation in or traveling to or from the event. I hereby state, that I am in proper physical condition to participate in this event and am aware that participation could, in some circumstances, result in physical injury. I further agree to indemnify the Shebandowan Fall Bass Classic et. al. (mentioned above), from any claims or damages arising out of or in consequences of the participation or attendance by me in this event. If under the age of eighteen, this waiver of claim, release and indemnification agreement must be signed by a Parent or Legal Guardian.
Entry and Acknowledgement:
Having read the rules and regulations, I hereby submit my entry form for the registration and enclose my entry fee payable to the Shebandowan Fall Bass Classic. By signing this form I agree with the rules and agree to abide by said rules.
 
Captain’s Signature: ________________________ Date: _______________
Partner’s Signature: _________________________Date: _______________
 
Please make cheques/money orders payable to the Shebandowan Fall Bass Classic.
Please send all cheques or money orders to Shebandowan Fall Bass Classic, 2714 E. Chruchill Dr, Thunder Bay, Ont, P7C-1V3