17th Annual ANG Bass Tournament
Hosted by:
123d Airlift Wing, Kentucky Air National Guard Make checks payable to:
ANG Bass Tournament / Kristin Hamilton
Mail Entry Fees & this completed for to:
Kristin Hamilton
311 Waterford Ridge Court
Mt. Washington, KY 40047-5540
Boaters Name/Rank__________________________________
Address: ___________________________________________
City, State, Zip: ______________________________________
Amount- $160 for tournament fees and 'Big Fish' for each day
- $140 for tournament fees ONLY
Qualification Justification:
Guard Unit and Base/Retired/State or Federal Employee of ANG/ARNG/Active assigned/Immediate family member-provide proof on your affiliation for justification
___________________________________________________
Phone: (DSN, Duty or Home - Circle One)________________
Email address:______________________________________
T-Shirt size:________________________________________
Partner Name/Rank:_________________________________
Address:__________________________________________
City, State, Zip:_____________________________________
Present Unit and Base/Retired/State or Federal Employee of ANG/ARNG/Active assigned/Immediate family member-provide info on your affiliation for justification
__________________________________________________
Phone:____________________________________________
E-Mail address:_____________________________________
T-Shirt size:________________________________________
Entry Fee:$140.00 per boat
Optional Big Bass pot $10.00 per boat/per day
(Total will be $160 for entry and big bass pot for both days)
A. Liability Release: In signing this agreement, I hereby acknowledge this as a risk event and release the 123d AW, KYANG, FLW its officers, agents and sponsors from any and all damages, cost or expenses relating to injury of any persons or any property which I may sustain or which I may cause by reason of participation in or in connection with this tournament.
B. I ackowledge and understand that I am responsible for my own personal well being, health and condition of my equipment. Personal effects are my sole responsibility and not that of the tournament sponsors or staff.
C. I agree to comply with each and every provision of the rules and regulations of this tournament, which are incorporated and here by reference.
D. I acknowledge that I am qualified to participate in this event based on the requirements set forth: 1) Current Air National Guard/ARNG Member, 2) Retired Air National Guard/ARNG, 3)Active Duty assigned to an ANG/ARNG Unit, 4)State or Federal Employee of the Air National Guard/ARNG Unit, 5) Immendiate Family Member of 1,2,3 or (Immediate family is defined as: spouse, mother, father, son, daughter, brother, sister, legal immediate step).
E. I agree that my failure to furnish true and accurate information on this form will result in forfeiture of any money or prizes, and possible disqualification from this and future tournaments.
Refunds of entry fees will be given on a case-by-case basis.
I have read the above statements and agree to all conditions stated therein.
Signed________________________________ Date:___________
Signed________________________________ Date:___________