2012 FIVE LAKES TOURNAMENT TRAIL MEMBERSHIP FORM

BOATER NAME___________________________ADDRESS_________________________________

CITY____________________________STATE_____ZIP________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_____ZIP________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_______________________________________________________________________