Extreme Bass Anglerz

2012 Membership Form

www.extremebassanglerz.com

Name:  Phone Number: 

Address:  E-mail Address: 

  Circle One

How are you fishing the 2012 tournament trail? Individually Team

If fishing with a partner: Partner’s Name: 

Boat Make, Model, Motor, H.P.: 

Years fishing tournaments:  Favorite Lake/River: 

Tournament Trail’s fished: 

All updates for club standings as well as tournament results are posted on the Extreme Bass Anglerz website. Any changes to the schedule, cancellations, etc… will be posted on the website. It is your responsibility to check the website to obtain such information. If you do not have access to the internet, please find someone in the club in which you can contact to obtain such information. 

I have read and understand all of the Extreme Bass Anglerz tournament trail rules. I agree to comply with all rules and regulations of Extreme Bass Anglerz and understand that failure to comply with such rules and regulations as well as demonstrating poor sportsmanship and inappropriate behavior may result in immediate termination from the tournament, club, or sanctions/penalties will be given to me. My signature herein releases all individuals working these tournaments, Extreme Bass Anglerz club, as well as Extreme Bass Anglerz sponsors from any and all liability in any form for any occurrence of damages, injuries, or deaths that occurs as a result of my participation in tournament events. My signature also releases Extreme Bass Anglerz to use my name and my photographs on brochures, Extreme Bass Anglerz web site, and/or other material involving Extreme Bass Anglerz without my consent and without receiving any royalty for doing so. My signature also notes my agreement not to use any illegal substances as well as not consuming alcohol before or during tournament hours. My signature also notes my understanding that if I am protested by another Extreme Bass Anglerz member or my actions are brought into question by the Extreme Bass Anglerz Board of Directors and the Board of Directors vote that I am guilty and vote on a penalty in regards to my behavior, I will accept the penalty as final as well as without holding Extreme Bass Anglerz legally liable. Failure to do so will result in termination from Extreme Bass Anglerz.

 Name  Date

  $30.00 club duties have been paid