U.S.-C.A.T.S KANSAS DISTRICT MIDWEST CHAMPIONSHIP

TOURNAMENT REGISTRATION FORM

MAIL TO: Al Dieball - 614 Locust - Lawrence KS , 66044


  Entry Fee---225.00-if mailed by August 25 after that the entry fee is 250.00 cash.

 

Please, COMPLETE this form. Boat number will not be issued if form is incomplete.

 Thank you!

 

Date:
U.S.-C.A.T.S - KANSAS- MIDWEST CHAMPIONSHIP		 Boat#:(LEAVE BLANK OFFICE USE ONLY)
__________________________

*Tournament Registering For:
__________________________

 *Total Enclosed:
                      Entry$ _______________

ALL INFORMATION BELOW MUST BE FILLED OUT.

 THANK YOU!
Name:
__________________________________ 		Address:
__________________________________
City, State
__________________________________

Zip:
 __________________________________
Home Phone:
__________________________________		 Work Phone:
__________________________________
Fax:
__________________________________		 E-mail:
__________________________________

 

 
Partner's Name:
__________________________________ 		Partner's Address:
__________________________________
Partner's City, State
__________________________________		 Partner's Zip:
__________________________________
Partner's Home Phone:
__________________________________		 Partner's Work Phone:
__________________________________
Partner's Fax:
__________________________________		 Partner's E-mail:
__________________________________

 

 
(Third Person) *read below /Name:
__________________________________ 		Address:
__________________________________
City, State
__________________________________

Zip:
 __________________________________
Home Phone:
__________________________________		 Work Phone:
__________________________________
Fax:
__________________________________		 E-mail:
__________________________________
*Note third person will be allowed at all  tournaments. Must be 16 under or 65 over

I have read and understand the rules and tournament application. By signing, I agree to the rules and terms. I hereby waive and release USCATS, the host and tournament committee from liability regarding all accidents, injury, theft and/ or loss of items and/or damage incurred in connection with the tournament(s). Official statements made the day of each tournament (prior to start time) take precedence over printed material. Entry fee is non-refundable, final decision made by majority vote of USCATS committee members.

Signature:
__________________________________		 Team Member:
__________________________________

Third Person:

____________________________________

MAIL TO: Al Dieball - 614 Locust - Lawrence KS , 66044

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