OFFICIAL ENTRY FORM
5th ANNUAL - TRI CITY BASS
FATHER'S DAY - OPEN TOURNAMENT
Lake Wisconsin - Saturday, June 17, 2023

Partner #1 (Please print):                                     Partner #2:

Name:_______________  Name:

Address:_  Address:_

City, State, Zip:  City, State, Zip:

Telephone:_  Telephone:_

E-Mail:_  E-Mail:______________

We understand and agree that the tournament committee reserves the right to refuse and refund
this entry fee for any reason.  Having acquainted ourselves with the rules, we have completed this
application and are enclosing our entry fee of $120.00 per team, payable to Tri City Bass.
(Big Bass included in entry fee.)
In signing this application, we hereto agree to hold harmless all other contestants, the host, sponsor,
and Tournament Officials.  Furthermore, we waive and release the rights to claims for damages or
injury that may be incurred during this tournament.

__________________________________   __________________________________
Signature of Partner #1                      Date           Signature of Partner #2                  Date

To Enter:
Print and fill out the above Official Entry Form and mail along with your entry fee of
$120.00 per team to:

TRI CITY BASS
Attn: Dave Green
465 Main St
Loganville, WI 53943
608-963-8473
Email: dgreen@wicw.net