Old Farts Team Tournament - Entry Form


Captain Name: ________________________________________________________________


Address: ____________________________________________________________________


City: ______________________________State: _______________Zip: _________________


If you would like an email acknowledgement that your entry fee has been received provide your email

address: ___________________________________________________________________




Partner Name: ________________________________________________________________


Address: ____________________________________________________________________


City:  _____________________________State: ________________Zip: ________________



I/We have read, understood, and agree to abide by all rules and regulations associated with the Old Farts Tournament and hold harmless all sponsors volunteers and tournament officials from any and all claims for injury or damages.

Signed Captain


Signed Partner:____________________________________ Date:______________________

(parent must sign if either contestant is under eighteen)


Please make checks payable to The Banks Lake Bass Club


For information call:


Tom Melowitz 509 631-0934







Tom Melowitz
335 Mead Ave
Grand Coulee, WA 99133