2022 QUALIFIER ONLINE ENTRY FORM – The Bass Federation of Kansas

2022 Qualifier entry form

"*" indicates required fields

Boater Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone*

Email*

TBF membership number*

Co-angler Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Cell Phone*

Email*

TBF membership number*

AFFIRMATION

All contestants: Having acquainted myself with the rules. I have completed this application and am enclosing my entrance fee payable to TBF KS. In signing this application, I hereby waive and release all other contestants, the host, sponsors and tournament officials from all claims or injury and/or damages incurred in connection with this tournament. I further understand and agree that the Tournament Director reserves the right to refund this entrance fee if my application is not accepted for any reason. I swear the above facts are true and accurate to the best of my knowledge. By affixing my signature to this entry form, I give the Tournament Rules Committee the right to inspect my boat and motor and further agree to submit to a polygraph test should I be accused of any rule violation.

Affirmation*

I agree to the affirmation

This checked box has the full value and enforcement as my signature.

Boater Name/signature*

First Last

This has the same force as my signature

Date*

Affirmation*

I agree to the affirmation above

Co-angler Name*

First Last

This has the same force as my signature.

Date*