| Applications |
Print out and mail to: Kish Creek Trout Tournament,
c/o
Teresa L. King, 114 Pine Street, Reedsville, PA
17084 |
2010 Kish Creek Trout Tournament May 15th and 16th |
Last
Name:_____________________________
First
Name:____________________________
Address:_______________________________
City:__________________________________
State:_____
Zip Code:________
Phone Number: (___)
______-_________
**Pre-registration $15.00 by April 30th , $20.00
After
May 1st** Check the line if you would like
to
obtain any of the following:
___: Registration
___:
Electric Service, $10.00 (note: Electric is on a
first
come
first serve basis.)
___: 50/50 Entry, $5.00
___: Community Trout $1.00
Total
Enclosed:$________________
I hereby release the Kish Creek
Trout Tournament,
all participating organizations, and all
participating
sponsors of the Tournament from any loss of
property,
bodily injury, or loss of life that may occur in this
Tournament.
Signature:___________________________________
Badge Number:_______________(Offical Use Only)
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