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Crofton & Sons, Inc
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$65.00 PER BOAT Includes Big Bass |
Payback 5 Places |
| Name 1 _____________________________ | Name 2 ______________________________ |
| Address _____________________________ | Address _____________________________ |
| City ____________ State _____ Zip _______ | City ____________ State _____ Zip _______ |
| Phone ____________ S.S. # ______________ | Phone ____________ S.S. # ______________ |
| Boat Registration # _____________________ | Signature _____________________________ |
| Signature _____________________________ | Alt. Name _____________________________ |
The above signatures release all sponsors, officials, organizations, individuals, and host city from any and all liabilities in any form for any occurrence whatsoever resulting from my participation in this event. I agree to abide by the rules of this tournament without exception. I have read the tournament rules and understand each of them.
Mail entries to: Accent Marine, Inc. | 10414 Hwy. 92 E. | Tampa, FL 33610