Virginia Bass

Region 9 – Tournament Registration Form

Official Use

Boat #........

Tournament Site: ________________________Date: ________

CONTESTANT # 1: (Please Print Clearly, No Nicknames)

First Name: __________________________________

Last Name: __________________________________

Club: __________________________________

I hereby agree to abide by all Region 9 Rules and Regulations, including

submission to a Polygraph examination if requested by Region 9 Officials.

I further agree to waive and release Region 9 Officers and Committee

Members of all claims for injuries and/or damages incurred in connection

with this tournament.

Signature: ______________________________________

CONTESTANT # 2: (Please Print Clearly, No Nicknames)

First Name: __________________________________

Last Name: __________________________________

Club: __________________________________

I hereby agree to abide by all Region 9 Rules and Regulations, including

submission to a Polygraph examination if requested by Region 9 Officials.

I further agree to waive and release Region 9 Officers and Committee

Members of all claims for injuries and/or damages incurred in connection

with this tournament.

Signature: _______________________________________