BACKWATER BASSIN FISHING

Team member #1 __________________________________________________________________

Address__________________________________________________________________________

City________________________________ Zip code______________________________________

Phone ______________________________Cell_________________________________________

Email____________________________________________________________________________

Team member #2 __________________________________________________________________

Address__________________________________________________________________________

City________________________________ Zip code______________________________________

Phone ______________________________Cell_________________________________________

Email____________________________________________________________________________

MAKE CHECKS PAYABLE TO JEFF JOSLIN NOT BACKWATER BASSIN.

MEMBERSHIP $50

Konawa entry fee is $80

TOTAL PAID TODAY:

OPTIONAL POTS: MUST ENTER THESE 2 POTS BEFORE YOU FISH YOUR 1ST TOURNAMENT.

BIG BASS FOR THE YEAR $10 BIG STRINGER FOR THE YEAR $10

CIRCLE ONE BASSBOAT MINI BOAT TUBERS

MUST SIGN LIABILITY RELEASE FORM BEFORE YOU CAN FISH...............


	It is agreed that the angler shall make no claim of any kind against Backwater Bassin, or any Officer of the club. Under no circumstances will Backwater Bassin or any club Officer of Backwater Bassin be responsible for any injury or death that could occur while fishing in a Backwater Bassin tournament. It is also understood that each angler participates in a Backwater Bassin fishing event or tournament at his/her own risk. And there can be no claim to Backwater Bassin or it's Officers for injury, death, damage to fishing equipment or vehicle, or loss of personal property while fishing or attending a tournament, weigh-in, or event. FOR THE 2016 SEASON.
	I fully understand the above liability release, and shall make NO claim of any kind to Backwater Bassin or its' Officers.
1	Members name (print) _________________________________
	Members' signature ___________________________________
	Date ________________________________________________

2	Members name (print) _________________________________
	Members' signature ___________________________________
	Date ________________________________________________

TEAM TRAIL