Club Application

NAME: ______________________________   

DATE: ____________________

ADDRESS:________________________________

CITY: __________________________ STATE: ____________ ZIP:________

HOME PHONE: ________________

CELL PHONE: _______________

BOAT-MAKE: _______________________________

LENGTH: _____________

HORSEPOWER: _____________________

ELECTRIC? YES / NO.

LIVEWELL OR AERATED COOLER MANDATORY.

NUMBER OF YEARS BASS FISHING: _______

EMAIL ADDRESS:__________________________________________

IN SIGNING THIS APPLICATION, I HEREBY WAIVE AND RELEASE ALL OTHER CLUB MEMBERS, OFFICERS AND SPONSORS FROM ALL CLAIMS OF LOSS, INJURY AND/OR DAMAGE INCURRED IN CONNECTION WITH TOPWATER BASSERS OR TOURNAMENTS HELD BY TOPWATER BASSERS. I FURTHER UNDERSTAND AND AGREE TO THE RULES AND BY-LAWS OF TOPWATER BASSERS.

SIGNATURE: _______________________________________________

 COMPLETE APPLICATION IF INTERESTED IN JOINING AND CONTACT EDDIE KASPERZAK FOR MAILING INFORMATION. OR APPLICATION CAN BE EMAILED TO EDDIE KASPERZAK. ( WE DON'T ACCEPT ANY NEW MEMBERS ONCE THE SEASON BEGINS!!!! )