The Bago Walleye Club Invitational 2015 Membership/Entry Application CAPTAIN 1: Full Name ____________________________________Cell phone____________________ Address ___________________________________________________City ________________________ State ______ Zip ____________Email (must have)___________________________________________ Social Security # _____________________________________Triton Gold applicable? Y or N (circle one) CAPTAIN 2: Full Name ___________________________________Cell phone ____________________ Address ___________________________________________________City________________________ State _______Zip ____________Email (must have)___________________________________________ Social Security# ______________________________________Triton Gold applicable? Y or N (circle one) ALTERNATE 1: Full Name _________________________________Cell phone____________________ Address___________________________________________________City_________________________ State ______ Zip ____________Email: (must have)___________________________________________ ALTERNATE 2: Full Name _________________________________Cell phone____________________ Address___________________________________________________City_________________________ State_______ Zip____________ Email: (must have)___________________________________________ *Boater’s Insurance company (must have) _________________________________________________ *Boat manufacturer __________________________ *Motor manufacturer ______________________ The entry fees for the BWC tournaments are $160 per Tournament, which includes a $10 big fish entry. Make checks payable to: The Bago Walleye Club. Send payment to: The Bago Walleye Club, N4901 Church Rd, St. Cloud WI 53079. *Teams must pay for all 4 BWC tournaments to qualify for this season’s Championship. Entries for all 4 tournaments cannot be postmarked earlier than 2/23 and must be sent on or before 4/11. If openings still exist after 4/11 you may sign up for single tournaments, but entries must be post marked by the Monday prior to the tournament weekend. Please Note: There will be no late entries accepted & a 65-boat maximum per tournament or Championship. If 65 teams sign up for all 4 events the series will be full. First come, first serve! You may have up to 4 alternate partners. If more than 2 alternates are needed list full information on the back of this application. Alternate partners will be asked for Soc #’s if money is won. Check all that you’re applying for: {x} $40 team membership { } $20 single membership { } $160 Winneconne Park May 3{ } Team__________________________________________ $160 Menominee Park May 31{ } Team _________________________________________ $160 Menominee Park June 28{ } Team _________________________________________ $160 Menominee Park July 26 { } Team _________________________________________ Total $ ____________ *The total for all tournaments and membership for 2 Captains is $680 per year. Each alternate partner costs $20 per year. PLEASE PRINT CLEARLY Waiver A. Participation Agreement: I/We acknowledge that this is a professional sporting event governed by the rules that have been established by tournament officials and I/We agree to abide by these rules. I/We acknowledge that I have read a copy of these rules, available on the website, and that these rules relate to the safety of all participants as well as the fair sporting conduct of this event. The Tournament Official(s) shall act as the referee in all disputes and their decision based on their interpretation of the rules will be final and without legal appeal. I also understand there are never refunds for tournament entry fees. B. Release of Liability: I/We acknowledge participation is voluntarily in The Bago Walleye Club (BWC) activities. I/We agree to assume all risk of injury, death, damages, theft and loss to personal property, which may result from my participation in BWC tournaments and functions. I/We recognize that loss of property, injury or death could arise from the fishing and boating activities contemplated by the tournament and the risks normally encountered in open-water fishing from a boat may be enhanced by exposure to the elements and other risks inherent in outdoor competition. I/We acknowledge that the safety of all persons aboard the watercraft is a primary concern and is the responsibility of the owner/operator. I/We retain the right to not compete if I/We feel the risks are too great on any given day, however, I/We realize in so doing that I/We forfeit any claim to my entry fee. I/We release Bago Walleye Club Inc, its directors, officers, employees, sponsors, volunteers, and agents from claims for any and all injuries, costs and expenses, death, damage, claims and demands, liability, theft, fire, or any loss occurring in conjunction with any Bago Walleye Club Event. I/We warrant that we have no physical or mental defect relevant to these activities. C. Photo & Video Release: I/We acknowledge and agree that any and all photographs, videos or films taken during my participation in the tournament which includes me, my name and/or my boat may be used by the tournament organizers, sponsors or media without my prior consent and without royalties. Signature Captain 1 __________________________________date:________________ Signature Captain 2 __________________________________date:________________ Signature Alternate __________________________________date:________________ Signature Alternate __________________________________ date:________________ Mail Waiver and application to: Bago Walleye Club N4901 Church Road St. Cloud, WI 53079 Mail Waiver and Application to: *All rules, regulations and incentives listed at www.bagowalleyeclub.com By signing this form I acknowledge I have read and understand the Bago Walleye Club Invitational Rules and Regulations
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