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2012 MAINE BASS CHALLENGE OFFICIAL ENTRY FORM
We have read, agree and understand the rules and enclose the completed application. In signing this application, we hereby waive our legal venue, we hereby waive and release all other contestants, sponsors, and tournament officials from all claims for injury and/or damages incurred in connection with these tournaments and agree to all their rules and decisions. And that I maintain liability insurance and have verification of liability insurance on the boat I will use in these tournaments. NO CHECKS.
Boater’s Name________________________________________
Address________________________________________________
City____________________________________State____________Zip____________
Phone_________________________
Email___________________________________________________
Boat/Model________________ Motor______________ Year___________ HP___________
Boat Insurance Company______________________________
Policy Number __________________________ Expiration Date ___________
Signature__________________________________________
Partner’s Name: ________________________________________
Address________________________________________________
City____________________________________State____________Zip____________
Phone_________________________
Email___________________________________________________
Signature__________________________________________
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