April 17th By Central Valley Bass Club@ Wittcom CampGr Boat Ramp

TEAM ENTRY FEE:  $100
BIG FISH POOL:   $10

BIGGEST SMALL MOUTH:  $10

80% Payout for 1of 5 Boats

100% of All Options Pots.

Check In, Boat Inspection & Live Well Check @ 4:30am - 5:30am

Meeting/Rules5:30am  ---  Blast Off is at Safe Light
Weigh in at 4:00pm with Awards and Raffle to Follow

Signed Applications, Proof of Insurance & Checks made
Payable to CVBC must be received no later than
April 11th   2010 to be Eligible for Draw

 Additional questions please contact Mike Tate 503 566 7525 Or email  teddi_tate@comcast.net Or Stan Delbridge @ bassnforfun@msn.com Please mail signed Entry Forms, Payments and proof of insurance to Mike Tate  @ 3840 Saxon Dr S. Salem OR 97302            

Boater:

Non Boater:

Address:

Address:

City, St Zip:

City, St Zip:

Phone:

Phone:

PAID ENTRY FEE $100

BIG FISH  $10 YES  NO

BIGGEST SMALL MOUTH $10  YES   NO

I have completed my application and have enclosed my entry fee including any option money.  By signing this application, I hereby waive and release the Central Valley Bass Club, its Sponsors, Tournament Officials any and all other parties from all claims of injuries and/or damage incurred in connection with this tournament.

Boater Signature:

Non-Boater Signature: