ENTRY FEE $110____BIG FISH POT $20____TWT $50____DEPOSIT______......TOTAL PAID________

PARTNER #1: (Print)__NAME_______________________________________________PHONE #___________
CITY, STATE, ZIP__________________________________________________________________________
EMAIL ADDRESS:_________________________________________________________________________

PARTNER #2: (Print)__NAME_______________________________________________PHONE #___________
CITY, STATE, ZIP_________________________________________________________________________
EMAIL ADDRESS:_________________________________________________________________________

Having read the rules concerning this tournament & signed this application for entry, I agree to waive & release the
sponsors, other contestants, host marinas & their agents, polygraphers & tournament staff of all claims of personal
injury, property damage or loss thereof, loss of life or any other liability incurred by me or my partner while
participating in this event. I agree that the above statements are true & agree to take a polygraph test if requested &
will accept the decision of the polygraph operator & tournament director thereafter. I also have boat liability
insurance, a current Fishing License, the current Boat Owners Registration & current ID.

Partner #1 Sign:_______________________________________________________Date:________
Covers all 2022 PBC events.
Partner #2 Sign:_______________________________________________________Date:________
Covers all 2022 PBC events.

YEAR MODEL & MAKE OF BOAT YOU ARE USING FOR THIS EVENT:________________OWNER____________________

Mail Entries To: Doug Phillips--------------Make Check or Money Order out to 'Doug Phillips'

101 Rob Roy Road      Southern Pines, NC 28387    

Starting QUALIFIERS positions determined by the time entry is received for each event.

                                                               Flights determined by number of entries.  
Entries will be taken morning of the tournament up until blast-off. Others may enter up to 1 hour after blast-off.
                  PLEASE! CASH ONLY AT THE RAMP! Contact Phone Number ....
912-980-5936 Cell

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~Please read the rules first !


~~~LAUNCH SEQUENCES: Preregistered teams will be randomly drawn for starting spots in each Qualifier.

After that, teams will be assigned a starting spot in order as they enter.  Send entries in now. Drawing for starting spots

will be held Jan. 8th, 2022.

~Right Click on the Entry Form and Print out a separate entry form for EACH qualifier you want to fish.

~Fill entry forms out completely and either bring them to me at home or mail them in.

~You must pay a $10 non-refundable deposit for each individual event to hold a starting spot and pay the
balance in full at the boat ramp the morning of the event, or pay in full before event date. You can also pay at
the ramp morning of the event...cash only at the ramp!

~Fees for the 'Championship' will be taken ONLY the morning of at Jordan Lake.

~Make all checks or money orders out to: Doug Phillips.

~Please....No phone calls will be taken for entries. Call me, however, if you have
any questions about the events.

~Starting QUALIFIERS positions determined by the time entry is received for each event. Championship starting
spots will be determined by points.    ENTER TODAY!!!

Right Click On
Entry Form
To Print