1. No category

XIII.
FOR FREEPORT HUDSON ANGLERS OFFICIAL USE ONLY
APPLICATION & WEIGH-IN SLIP
(ONE APPLICATION PER ANGLER)
FREEPORT HUDSON ANGLERS FLUKE FRENZY TOURNAMENT
Last
First
_____OFFICIAL USE ONLY______
Angler’s Name: _______________ ______________
Entry #: ______________
Address: __________________________________
Check-in time: __________
__________________________________
Weight: _______________
Phone #: Home_________________ Cell_____________
Length: _______________
EMAIL ADDRESS: ____________________________
The information above is true.
Participants’s Signature: __________________
Division: Adult_________ Junior________(Age)______
Weigh-Master Signature __________________
DISCLAIMER AND ASSUMPTION OF RISK – I attest to have read and understand
the entire disclaimer and assumption of risk affidavit.
Print Your Name: ____________________________
Date: _________________
Sign your name: ____________________________
Check here if this is for a Junior Division Participant ________
Check the appropriate areas (one applicant only):
Adult Division $25 ______
Junior Division $10 _____
$25 Calcutta $25 ______
$50 Calcutta $50 ______
Cash __________ Check__________ Total________ I have submitted a total of $_________________
Participant’s Signature: ________________________________
FHA Member: (Print & Sign) ____________________________