M.S.S.A. Frederick Chapter Angler of the Year Entry Form
http://www.mssafrederick.com

2004 Angler of the Year - Entry Form
 

Angler:_____________________    MSSA Membership #:____________

Adult:  [   ]           Chesapeake Bay: [   ]   $10.00 Make checks payable to:
MSSA Frederick Chapter
Junior:  [   ]           Atlantic: [   ]   $10.00
  Both: [   ]   $15.00

I have read and understand the MSSA FREDERICK CHAPTER ANGLER OF THE YEAR CONTEST REGULATIONS. I agree to comply with the regulations. I agree that the decisions of the Rules Committee are final. I understand that: I fish at my own risk; that the M.S.S.A. FREDERICK CHAPTER shall not be liable for any injury which I may incur participating in this Contest; and that my participation in this contest is strictly voluntary.


____________________________            ________________
Angler Signature                                           Entry Date


2004 Rules Committee Certification of Angler
 
MSSA member in good standing?   [yes]   [no ]  
Frederick Chapter member in good standing?   [yes]   [no ]  
Entry Fee Paid?   [yes]   [no ]  
If/was a "Junior Angler" is under 15 at time of application?   [yes]   [no ]  
Entry fee paid?   [yes]   [no ]  
____________________________
Angler Number

For the MSSA Frederick Chapter:

____________________________            ________________
By: Authorized Rules Committee Member                   Date
 
 
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Updated:   04-Feb-2004