Angler's Edge

Official Entry Form

Enclose completed form with entry fee payable to Angler's Edge. In signing this application, entrants waive and release all contestants, sponsors and event officials from all claims for injury and/or damage incurred in connection with the event. Entry constitutes permission to use names & pictures for publicity purposes. Date entry received determines start position. Checks or money orders must accompany this form to qualify for entry. No post dated checks accepted. You must complete all blanks and signed to be accepted.

Captain _________________________  Partner _____________________________

Address_____________________  Address________________________

City,St,Zip_________________ City,St,Zip_____________________

Phone,Email_________________ Phone,Email_____________________

Age,Soc.Sec.#_______________ Age,Soc.Sec.#___________________

Signature___________________ Signature_______________________

Membership fees if applicable________ Membership fees if applicable_________

Ramp feess if applicable___________ Ramp feess if applicable________________

Big Bass(Optional):_____________________________

  Savanna Events Add $7.00 For Ramp Fee

Madison Events Add $10.00 For Green Lantern Facility Use

Big Bass Pots, (100% Payback, Opitional): PBS, SBL, RBL, Angler's Edge

Mail Entries to: Angler's Edge, 217 E. Riverside Blvd.

Loves Park, IL 61111 815-877-6062

Visa & Mastercard Accepted,$7.00 Processing Fee