Piedmont Bass Classics

Jordan Lake          DECEMBER 3rd, 2022  FARRINGTON BOAT LAUNCH  
Time: Safe light- 8 hours Times to be announced based on conditions prior to event

PARTNER #1: (Print)
NAME_______________________________________________PHONE #_________________
ADDRESS_________________________________________________________________________________
CITY, STATE, ZIP__________________________________________________________________________
EMAIL ADDRESS:_________________________________________________________________________

PARTNER #2: (Print) 
NAME_______________________________________________PHONE #________________
ADDRESS_________________________________________________________________________________
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:________
Partner #2 Sign:_______________________________________________________Date:________

Mail or email scanned entries to: Doug Phillips 101 Rob Roy Road, Southern Pines, NC 28387 or flroutdoorsllc@gmail.com.

Make Check or Money Order out to FLR Outdoors, LLC
Starting positions determined by time entry is received. Flights determined by number of entries with 25 boats per flight.  
Entries will be taken morning of the tournament up until blast-off. Others may enter up to 1 hour after blast-off.
CASH AND CREDIT ACCEPTED AT THE RAMP!   Contact Phone Number: Doug 912-980-5936 Gretchen 337-348-9003

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