2012 MEMBERS INFORMATION

BOATER

NAME: ________________________________________________                                                    

ADDRESS: _____________________________________________                                                    

CITY: __________________________________________ST. FL  ZIP: _______________________

HOME PHONE: _______________________________CELL PHONE: ______________________

E-MAIL ADDRESS: _____________________________________                                                    

B.A.S.S. # : __________________________________________ EXP: ________________________

SIGN : __________________________________________ DATE: __________________________

NON-BOATER

NAME: ________________________________________________                                                    

ADDRESS: _____________________________________________                                                    

CITY: __________________________________________ST. FL  ZIP: _______________________

HOME PHONE: _______________________________CELL PHONE: ______________________

E-MAIL ADDRESS: _____________________________________                                                    

B.A.S.S. # : __________________________________________ EXP: ________________________

SIGN : __________________________________________ DATE: __________________________

 

Monthly Tournaments $50.00 and Optional $10.00 Big Bass             

                             * Must pay                     Boater                 Non-boater

CLUB DUES:                                       $25.00 ___*           $25.00 ___*      

National B.A.S.S. Federation Dues    $30.00 ___           $30.00 ___             

Florida B.A.S.S. Federation Dues      $15.00 ___             $15.00 ___

BOATER           CASH ___ CHECK ___Total amount:  ________ CHECK # __________

NON-BOATER CASH ___ CHECK ___ Total amount:  ________ CHECK # __________

Make Checks Payable to: South Pasco Bassmasters

 

In signing this agreement, I hereby release South Pasco Basssmasters, its officers, agents, employees and sponsors from any and all damages, claims, demands, cost or expenses relating to injury of any person(s) or any property, which I may sustain or which I may cause by reason of participating in or in connection with any and all South Pasco Bassmasters events.

 

Covenant not to sue and Waiver of Subrogation:   I further agree that I will never sue South Pasco Bassmasters for damages on account of any injury or damage I suffer or cause whether known now or which may develop in the future. In the event South Pasco Bassmasters is sued because of my actions, I expressly agree to indemnify and hold South Pasco Bassmasters harmless from any liability whatsoever, including court cost and attorney’s fees, arising with respect to such actions.  I understand that in waiving my rights to sue South Pasco Bassmaster, I am also waiving my rights of recovery from South Pasco Bassmasters of my Insurance carrier for any claims they may pay on my behalf. I further understand that by signing this agreement I waive any rights my heirs or relatives have or may have to sue South Pasco Bassmasters for liability.  This Covenant and all it’s conditions will also apply to protect and release a Member Boater from any and all issues with respect to damage or injury a non-boater may sustain or cause while on the members boat during any and all South Pasco Bassmasters events including actual tournament day and pre-fishing events.