Scholarship Tournament - Entry Form

 

 Return to Banks Lake Bass Club Web Site



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 Banks Lake Open and hold harmless all sponsors volunteers and tournament officials from any and all claims for injury or damages.



Signed Captain
:____________________________________
Date:______________________

 

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 or 509 633-2282

Tom_Melowitz@yahoo.com

 _____________________________________________________________________

 

 

MAIL TO:

 

Tom Melowitz
335 Mead Ave
Grand Coulee, WA 99133