Print out and mail to: Kish Creek Trout Tournament,
c/o Teresa L. King, 114 Pine Street, Reedsville, PA 17084

2008 Kish Creek Trout Tournament May 17th and 18th

     Last Name:_____________________________

     First Name:____________________________

     Address:_______________________________

     City:__________________________________

     State:_____                      Zip Code:________

     Phone Number: (___) ______-_________

**Pre-registration $10.00 by April 30th , $15.00 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
 

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)