Date:
Team
Captain Name:
Phone:
Email:
Address:
City:
State:
ZIP:
Main Division - $70
Big Trout Division - $20
Double Down Main - $70
Double Down Big Trout - $20
Angler #2 Name:
Phone:
Email:
Address:
City:
State:
ZIP:
Main Division - $70
Big
Trout Division - $20
Double Down Main - $70
Double Down Big Trout - $20
Total Amount (include correct entry and optional big
trout division entries):
If fishing as a team you must include entry for entire team.
Team Captain Signature:
__________________________________________________Date:
PARTICIPANT AGREEMENT, RELEASE AND ACKNOWLEDGEMENT OF RISK: Upon signing
this application, I hereby waive & release all other contestants, host
sponsors and tournament officials from any and all liability claims,
demands, actions or rights of action which are related to, arise out of,
or in any way connected with my participation in this tournament, for
any and all claims of death, personal injury, accidents, theft and
damage to myself, my partner, to others and all equipment involved in
fishing. I voluntarily assume full and all responsibilities for my
health and safe being arising from my participation in this tournament.
I assume responsibility for all equipment on and off water during this
tournament. I have sufficient health, accident, and liability insurance
to cover any bodily injury or property damage incurred by myself or
others as a result of my participation in this tournament. If I have no
such insurance, I represent that I am capability of paying for any and
all such expenses or liability. I have read and understand the rules of
this tournament and I will obey all rules and understand that any
violation may result in immediate disqualification without refund of my
entry fee. I also understand that tournament officials may reject my
application for any reason and in that event will refund my entry fee.
By signing this application, I will submit to a polygraph if requested
to do so. If I fail to pass the polygraph, I will be disqualified.
Plugger Open Fishing Tournament Series has my permission to use my
name, photograph and film footage of me if it chooses to do so. My
signature above reflects that I have read the entire document,
understand it completely, understand it affects my legal rights and
agree to be bound by its terms. References to “I,” “me,” “my,” “myself,” and other first person references shall include any child or ward to
whom I sign.
Adult Signature:
________________________________________________________Date:
(If team captain is under 18 years of age) I hereby claim responsibility
for the minor above and have read and understand
the rules and release all of the above affiliated with the event from
all claims above..
BEFORE YOU HIT SUBMIT PLEASE
PRINT ENTRY FORM TO INCLUDE WITH YOUR CHECK IN THE MAIL.
Mail Entries at least 3 days before the event. Make checks payable to:
Plugger Open, 8519 Bluegate St., Houston, TX 77025.
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