2011
Entry Form
2011
Entry Form
Each tournament entry fee is $75.00 per team and Membership dues are $20.00 per person.
April 9
Eastfork Lake
May 7 Grand Lake St. Marys
April 16 Caesars Creek
May 21 Indian Lake
April 30 Buckeye Lake
June 4 Lake Loramie
Sept 17 Delaware
Please circle the tournaments you wish to fish.
Total Entry Fees:
$ _________
Membership Fees:
$ __________
Big Fish:
$__________ (optional $10)
Late Fee
$__________ ($10)
Total Fees
$__________
Late fee (if not received 7 days prior to tournament) $ 10.00
Team Member #1: ____________________ Address: _______________ City: __________
State: _____ Zip: _____ Phone #: _______________ E-Mail: _______________SSN_____________
Team Member #2: ____________________ Address:_____ __________ City: __________
State: _____ Zip: _____ Phone #: _______________ E-Mail: _______________SSN_____________
I hereby release Buckeye Crappie challenge, its Sponsors, Members and the State of Ohio from any bodily injury, or loss of property, that
may occur during all events and tournaments. I also agree to abide by all the tournament rules, and all state and local laws. Any violation will result in disqualification from this tournament and possibly future tournaments as the tournament director determines necessary. I also agree to submit to a polygraph and or voice stress test and to abide by the decision or said operator of the tests.
Member #1 Signature: _______________
Member #2 Signature: _______________
Make all checks payable to Buckeye Crappie Challenge, and Mail to:
Buckeye Crappie Challenge P.O. Box 394 St. Marys, Ohio 45885
For further information Call Jeff at (419) 305-8762 or
Russ at (419) 394-1261 or E-Mail at Postmaster@buckeyecrappiechallenge.com