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Rogue Valley Bassmasters
Registration/Release Form
New Member
Yes _____
No _____
NAME _________________________________________________________________
ADDRESS ______________________________________________________________
CITY ______________________________STATE
_________ ZIP __________
PHONE (_____) ___________________
EMAIL ADDRESS ______________________________________________________
BOAT OWNER
Yes _____
No _____
MEMBERSHIP: Family-Plus
- $40 ____ Family - $30 _____Single - $25 _____
FAMILY-PLUS = FAMILY + RELATIVES.
NAMES REQUIRED BELOW:
RELEASE
I, __________________________________,
do hereby release the ROGUE VALLEY BASSMASTERS of any obligation both of any damages to my person or property occurring at
any and all club tournaments for the year _______. This release includes all manner and causes of action,
suits, debts, dues, sums of money, accounts, bonds, bills, covenants, contracts, controversies, agreements, promises, variances,
trespasses, damages, judgments, execution, claims, and demands whatsoever. I know that any legal fees involved
in any and all actions will be the responsibility of myself and no fees will be held accountable to the ROGUE VALLEY BASSMASTER
or any person associated with this organization/club.
Signature: _________________________________
Dated: ______________________
Mail completed form to: Andy McBee, 965 Old Ferry Rd., Shady Cove, OR
97539
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