2009 BASSSOUTH MEMBERSHIP FORM
Please PRINT clearly the following information.
NAME________________________________________
ADDRESS_________________________________________
CITY____________________________STATE____________
ZIP__________________BELLSOUTH EMPLOYEE: Y__N__
PHONE_____________________ CELL_________________
EMAIL_____________________________________________
SIGNATURE________________________________________
DATE_____________________________________________
In signing this application, I waive and release all contestants, host sponsors and tournament officials from all claims of injury, loss and/or damages incurred in connection with any of the 2009 BASSSOUTH BASS TOURNAMENTS.
Please fill out and bring with you on tournament day.