ENTRY FORM
Wallkill Rod and Gun Club and Marlboro Yacht Club
15th Annual Hudson River Striped Bass Tournament

In consideration of being accepted as a participant in the Wallkill Rod and Gun Club and Marlboro Yacht Club Striped Bass Fishing Tournament, I hereby release and discharge the Wallkill Rod and Gun Club and the Marlboro Yacht club and their Officers, directors, agents, and employees from all claims, demands, or causes of action out of or resulting from any anticipated or unanticipated incident resulting from participation in the tournament. I understand that the contest sponsors assume no responsibility or liability for any boats entered or participating in the contest. I understand that the contest will be held rain or shine and that it is the sole responsibility of the captain of all entered boats to determine if the weather and river conditions are safe to fish. I recognize that the rules are posted on the website and I will print them out for my reference. I hereby state that I have read and understand all these rules, regulations, and disclaimers and agree to abide by them.
Name: __________________________________________________________________
Address: ________________________________________________________________
City: _________________________________ State:_________Zip Code:____________
Phone: (______) _________________________________ Age: ____________________
Entrant's Signature: _______________________________________________________
Parent or Guardian's Signature:______________________________________________
If entrant is under 18 years old.
Were you a tournament participant last year? (circle) ***YES*** ***NO***
Entry fee is $30.00, ($20.00 under the age of 18) and must be
submitted with a properly completed entry form.
Entry forms accepted after May 17th will be considered late and
thereby subject to a $35.00 entry fee.
Entry fees are not refundable unless the director cancels the
tournament.
Tournament fishing starts at 12:00 A.M., Saturday, May 17th, and
ends when the scales close at 5:00 P.M. Sunday, May 18th.
Make check payable to: Wallkill Rod and Gun Club then mail along with entry form to:
| Wallkill Rod and Gun Club |
| PO Box 402 |
| Wallkill, NY 12589 |
or drop form off at:
| Wallkill Rod and Gun Club |
| 316 Bruyn Turnpike |
| Wallkill, New York |
or
| Ceely's Bait and Tackle |
| Sloop Hill Road |
| New Windsor, NY |