2010      
Entry Form

Each tournament entry fee is $75.00 per team and Membership dues are $20.00 per person.

              April 17 Eastfork Lake                                  May 22 Grand Lake St. Marys
April 24 Saltfork Lake                                    June 5 Delaware Lake
           May 8 Buckeye Lake                                    Oct 2 Indian Lake                 
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