BOATER NAME___________________________ADDRESS___________________________

CITY____________________________STATE_________CELL PHONE_________

MARRIED/SINGLE(circle one) SPOUSE'S NAME___________________________

OCCUPATION___________________E-MAIL ADDRESS______________________

HOBBIES_________________AGE_____CHILDRENS NAMES_________________

# OF YEARS FISHING____________# OF YEARS FISHING WITH FLFC_________

BOAT AND MOTOR MAKE_________________________________

FAVORITE LURE/PATTERN____________________________________________

FISHING PARTNER__________________# OF YEARS FISHING TOGETHER_____

My signature below releases any officer of the FIVE LAKES FISHING CLUB from any liability before during or after any scheduled tournament.

SIGNATURE_________________________________________________________

PARTNER NAME___________________________ADDRESS___________________________

CITY____________________________STATE_________CELL PHONE_________

MARRIED/SINGLE(circle one) SPOUSE'S NAME____________________________

OCCUPATION____________________E-MAIL ADDRESS_____________________

HOBBIES___________________AGE_______CHILDRENS NAMES_____________

# OF YEARS FISHING___________# OF YEARS FISHING WITH FLFC__________

BOAT AND MOTOR MAKE________________________________________

FAVORITE LURE/PATTERN____________________________________________

FISHING PARTNER___________________# OF YEARS FISHING TOGETHER___

My signature below releases any officer of the FIVE LAKES FISHING CLUB from any liability before during or after any scheduled tournament.

SIGNATURE_________________________________________________________