2015 ENTRY FORM
A Production of DBPF Productions, LLC.
TABLE ROCK LAKE
LAKE OF THE OZARKS
March 21, 2015
Headquarters: Town & Country Motel
Registration: PB #2 Boat Ramp
Reg. Time: 4:00 pm - 6:30 pm
Take-off: 7:00 am-3:00 pm @ PB #2
BULL SHOALS
September 12, 2015
Headquarters: Chandler’s Inn
Registration: Bull Shoals Boat Dock
Reg. Time: 4:00 pm - 6:30 pm
Take-off: 6:30 am - 3:00pm
@ Bull Shoals Boat Dock
417-861-2983
STOCKTON LAKE
April 18, 2015
Headquarters: Lighthouse Lodge
Registration: Table Rock Bait & Tackle
Reg. Time: 4:00 pm - 6:30 pm
Take-off: 6:30 am - 3:00 pm
@ Mill Creek
May 9, 2015
Headquarters: Orleans Trail Resort
Registration: Orleans Trail Resort
Reg. Time: 4:00 pm - 6:30 pm
Take-off: 6:00 am - 2:30pm
@ Orleans Trail Marina
OMTT CHAMPIONSHIP
B.A.S.S. TEAM
CHAMPIONSHIP
October 10-11, 2015
100% Payback
1st Place Ranger Boat
/Mercury Motor
Lake Guntersville, AL
December 9-12, 2015
Go to www.respoolin.com
for more details
• 100% Payback Tournaments • Guaranteed 25 places paid at each event • NO Umbrella Rigs Rule #27
• $1000 Ranger Cup to Winner or $500 to highest finisher (*must be Ranger Cup Member)
• Ranger/Mercury Draw Boat • $50 insurance Incentive to highest finisher (*must be with Scott Berry Agency)
• Solarbat Incentive • 2 Day Championship Ranger Boats/Mercury Motor.
BOATER (Required information)
go to
www.respoolin.com for more info
PARTNER (Required information)
Name ____________________________________________________________
Address___________________________________________________________
City _____________________________ St. _______ Zip____________________
Phone # _____________________ Cell #________________________________
Email Address______________________________________________________
SS# _________________________________ DOB_________________________
Boat Insurance Company_____________________________________________
Boat _______________________________ Year/Model____________________
Motor/Year_________________________ Horse Power____________________
Trolling Motor _______________ Electronics_________________ Talon/PPole
Batteries ___________________ Tow Vehicle____________________________
Rod Brand __________________ Reel Brand ____________________
BOATER SIGNATURE________________________ DATE_______________
Name ____________________________________________________________
Address___________________________________________________________
City _____________________________ St. _______ Zip____________________
Phone # _____________________ Cell #________________________________
Email Address______________________________________________________
SS# _________________________________ DOB_________________________
Boat Insurance Company_____________________________________________
Boat _______________________________ Year/Model____________________
Motor/Year_________________________ Horse Power____________________
Trolling Motor _______________ Electronics_________________ Talon/PPole
Batteries ___________________ Tow Vehicle____________________________
Rod Brand __________________ Reel Brand_____________________________
PARTNER SIGNATURE______________________ DATE_________
LIABILITY RELEASE: In signing this application, I hereby waive and release the boats, agents, other contestants, any sponsors, all tournament officials, Ozark Mountain Team Trail, and DBPF Productions, LLC, from all charges,
claims, demands, cost or expenses relating to injury I may sustain or which I may cause by reason of participation in all OMTT tournaments. I agree that OMTT will have exclusive rights to take photographs, video, motion pictures or
audio recording to use such material in a lawful manner. I also agree to abide by the OMTT Tournament Directors decisions and agree there is no right to appeal his or her decisions.
LIABILITY BOAT INSURANCE In signing this application, I verify that I have boating liability insurance in the amount of $100,000 and I have listed my insurance provider above. By my signature, I have read and understand the rules
and agreements provided by OMTT and DBPF Productions, LLC.
MAIL TO:
OMTT • 4192 N FR 101 • Springfield, MO 65803
• All entries are to be paid by Cash, Credit Card or Check made out to
OMTT (Returned check subject to $50 service charge).
• Must fish 4 out of 4 tournaments with only 1 alternate to Qualify for
Draw Prizes!
• Boat order will be determined by date of entry.
• Form of
Payment
Visa
Mastercard
Discover
Check American Express
Entry Fee $200 per event ($210 by CC)
LOZ
TR
ST
BS
Big Bass $20 per event
Boater Membership $40 annual
Non-Boater Membership $40 annual
Cash
Credit Card Number: ____________________________________
Name on Card: _________________________________________
Expiration Date: ____________ Three digit number on back of card: ____ ____ ____
TOTAL AMOUNT
ENCLOSED:
Non-refundable $50 deposit will reserve your take-off number.
NOTE: Deposits are non-refundable and balances must be paid in full by registration!