Registration Form for Your Team
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File Type：pdf, Size：1020Kb
GEORGIA B.A.S.S. NATION
2016-2017
REGISTRATION FORM FOR YOUR TEAM
NAME OF ANGLER:
ADDRESS
CITY STATE: (GA) ZIP:
PARENT or GUARDIAN:
PHONE NUMBER 1: Number 2: PLEASE PROVIDE 2 CONTACT NUMBER
PARENT EMAIL:
BIRTHDATE OF ANGLER:
SCHOOL:
Coach/Sponsor at school name & email address:
Contact: Michelle L. Volk
Georgia BASS Nation High School Youth Director
85 Shepherd Drive, Lithia Springs, GA 30122
770-206-0120
Dues for GA BASS Nation High School fishing are $10.00 per angler Tournament Registration Form
LAKE:
SCHOOL: ______
ANGLER 1: ______***ALL ANGLERS ARE REQUIRED PH#: ______TO SHOW PROOF OF BOATER SAFETY COURSE AT CHECK IN FOR ANGLER 2:______EACH EVENT***
PH#:______
(Student anglers must attend same school and provide proof)
Boat Captain: ______
PH#: ______
Boat: ______
Motor: ______
Color: ______
***Waivers MUST accompany tournament registration, 1 waiver per angler per lake***
Event fee: 50.00/boat (registered 3 days prior to event) checks payable to GABNHS
60.00/boat (if registered 3 days leading to event Weds, Thurs Friday)
*****If you choose to pay on DAY OF EVENT there will be a $25.00 PENALTY*****
Mail entry form and waivers:
Michelle Volk
85 Shepherd Drive
Lithia Springs, GA 30122