WEST VIRGINIA BASS FESTIVAL ENTRY FORM
BOATER _________________________________________________________ STREET _________________________________________________________ CITY ___________________________________________________________ STATE _________________________ ZIP ___________________________ PHONE __________________________________________________________ BOATER SSN _____________________________________________________ E-MAIL _________________________________________________________ SIGNATURE ______________________________________________________
*Must attach proof of $100,000 liability insurance.
PARTNER ________________________________________________________ STREET _________________________________________________________ CITY ___________________________________________________________ STATE _________________________ ZIP ___________________________ PHONE __________________________________________________________ BOATER SSN _____________________________________________________ E-MAIL _________________________________________________________ SIGNATURE ______________________________________________________ PARTNER SSN ____________________________________________________
*Must attach proof of $100,000 liability insurance.
SEND YOUR COMPLETED ENTRY FORM WITH $215 ENTRY FEE TO
WEST VIRGINIA BASS FESTIVAL
PO BOX 404, ST. MARYS, WEST VIRGINIA 26170