Top Stick Joes Entry Form

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John Barron
Posts: 3494
Joined: Mon May 09, 2005 5:05 am
Location: Central Valley, CA

Top Stick Joes Entry Form

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Top Stick Joe Entry Form
Boater: Name_________________________S.S.______________________________________
Address_____________________________________City______________Zip_______
Phone(______)__________Signature________________________Email___________
Non-Boater: Name_________________________S.S.______________________________________
Address_____________________________________City______________Zip_______
Phone(______)__________Signature________________________Email___________
I have completed this application and have submitted the total fees needed for participation. In consideration for the privilege of participating in this tournament, I hereby release all tournament officials and sponsoring organizations from all claims of injury and/or damages incurred in connection with this event. I understand that I may be subject to a polygraph exam and that the tournament promoters reserve the right to refuse entry and services to anyone. I release any photos or videos of me.
PLEASE CIRCLE OPTIONS ENTERED
Entry Fee____________________ $100 mandatory
Insurance____________________ $15 mandatory
Event fee_____________________ $5 mandatory
Big Fish______________________ $10 option
Husband/Wife________________ $10 option
Father/Son or Daughter________ $10 option
Top 3 Teams_________________ $10 option
All American_________________ $10 option
Non Bass option______________ $10 option
Total Paid ______________________________

Club Affiliation_______________________________________
Prepaid entries can be done by credit card by calling Marla Barron at 909-263-7125 or faxed to 909-592-7671
Credit card number__________________Expiration date________________
Billing zip code____________________
There is a 3% surcharge for use of credit cards. PayPal also available
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