Team # Sunday, January 31, 2016 Official EnTry fOrm rules meeting Saturday, January 30, 2016 Entry Fee $200.00 per team – Payment Method • Cash • Check • Credit Card Make checks payable to MidwEst OPEn iCE Fishing tOurnaMEnt Credit Card Exp. date CVV name on Credit Card fisherman #1 – Team captain name ___________________________________________________________________________________________ Youth address _____________________________________________________________________________________________ City ________________________________________________________ state ___________ Zip _________________ Cell Phone # _________________________________ Evening Phone #__________________________________ E-mail________________________________________________________________________________________________ fisherman #2 FishErM an # 2 is rEQ uirEd tO bE FillEd Out at tiME OF E ntrY name ___________________________________________________________________________________________ Youth address _____________________________________________________________________________________________ City ________________________________________________________ state ___________ Zip _________________ Cell Phone # _________________________________ Evening Phone #__________________________________ E-mail________________________________________________________________________________________________ are you already qualified? Past Champion 2015 Midwe st Ope n Qualifier 2015 Michigan O pen Qualifier Check here to receive special offers, new product information and other important e-mail communicatons from our sponsors. Mail to: Knutson’s recreational sales • 164 wamplers lake road • brooklyn, Mi 49230 Phone: 517-592-2786 • Mi 1-800-292-0857 • usa & Canada 1-800-248-9318 • Fax 517-592-3249 Register online at MidwestOpenTournament.com