[Ryan G.]

CONNECTICUT JR. BASS NATION, INC. Presents

MAKE-A-WISH-FOUNDATION TEAM TOURNAMENT

To Benefit the Make-A-Wish Foundation of CT
$35.00 per entry will be used to make a donation in
the name of the Middle School of Plainville.

Sunday November 17, 2013
Candlewood Lake, Squantz Cove 7:00am to 3:00pm

Entry Fee $110.00 per team
Morning Registration begins at 5:30am.
Applications will be accepted the morning of the tournament CASH only.
Lunker pool is included with this entry fee.
There is an 8 fish limit and you will be allowed one courtesy measurement at the scales. Boat Numbers will be assigned by random draw. Max of 40 boats.

Payouts –
$35.00 per entry goes to Middle School of Plainville
who will donate to the Make-A-Wish-Foundation
$10.00 per entry goes towards Lunker
$65.00 per team is paid back to 5 places

In consideration of being accepted in the Make a Wish Team Tournament, the undersigned hereby releases and discharges the CBN,CJBN
it’s officers, all sponsors and hosts, from all claims, demands, rights of action, present or future, whether known anticipated or unanticipated and resulting from or arising out of, or incident to the undersigned’s participation in the Tournament.

By signing this application you agree that your boat is covered by a minimum of $300,000 of liability insurance and verify
that this coverage will be in force the day of the tournament. CBN Tournament Rules apply. (www.CTBASS.com)

__________________________ ___________________________________
Boater’s Name (Please Print) Partner’s Name (Please Print)

Address__________________________Address______________________

City____________________________City________________________

State______Zip_____________ State_______Zip_____________

Phone #__________________________ Phone #_______________________

Signature______________________Signature_______________________

Boat Make____________Length______Rated HP______Actual HP________

Applications must be completely filled out and signed by both anglers.