Ontario B.A.S.S. Federation Nation Qualifier Entry Form

Qualifier’s Name__________________________________________

Address ________________________________________Apt. ____

City _____________________________________ P/C _________

Phone # (____) __________________

Cell #    (_____)__________________

E-Mail____________________________________

( ) BOATER      ( ) NON - BOATER

OBF Chapter ______________________

Send all entries along with club cheque to:

Ontario Bass Federation

2673 Constable Road, Mississauga, ON. L5J 1W3

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Please print clearly and fill in all areas

Boat Make_____________________________

Model ________________________________

Motor Make _____________________HP____

Insurance

Company _____________________________

Policy # __________________

Expiry Date __________________

A copy of insurance form can be mailed in with registration or it mustbe present in your boat when asked and must be on your person at the mandatory meeting Friday night.

Documents that will be checked at Friday night meeting

B.A.S.S. Membership No #__________________________

Valid Fishing Licence/Card #_________________________

Boat Insurance Certificate

Parent/Guardian Signature is require for entrant under 18

Signature_____________________________________

No one under 18 will fish without Parent/Guardian consent

Check your BASS Card & BASS Federation card for validity, they are different. Fishing licence cannot be a conservation licence. Photocopy of your 2009 fishing licence must be sent in with your entry form.

Staying (where) _______________________________________  Room # ______   Phone # (___)  _____________

Team Captain ________________________ Staying at ____________________________   Phone #(___)___________

Signature __________________________________DATE________________ No entries accepted after Aug 15, 2009

Chapter Presidents Signature__________________________________ DATE _______________

Member in good standing ____Y___N

(Office only) received by OBF on________________________ Cheque received on __________________

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TOURNAMENT DATE & PLACE

Lake Muskoka, Gravenhurst, Ontario, August 29 & 30, 2009 - Entry Fee-$200.00

Meeting on Friday Aug 28th is MANDATORY. Location and time will be made available on the OBFN website

and to each Chapter President when it is determined.

Friday night meeting must be attended in person and you will be required to show Insurance (boater only), Valid BASS Federation &

BASS Card, and Valid fishing license (not just a valid card). A Conservation license is not acceptable.

No one entering into any Qualifying event will hold any sponsors, officials or hosts responsible for any damage or injury incurred in these

events, for any reason.

All rules & regulations of the OBF attached hereto apply, failure to adhere could result in disqualification & or loss of membership.