![]() |
| Registration# | Fishing License# | ||
| Time Weighed | Station signature | Weigh Master | Weight |
| Time Weighed | Station signature | Weigh Master | Weight |
| Last Name First name |
| Street Address PO Box, Apartment, Rural Route |
| City State/Province Zip/Postal Code County |
| Local phone during derby (if available) Home Phone |
DERBY DATES SEPT 13TH TO OCT 18TH 2003
PLEASE PRINT RULES, SIGN AND
MAIL TO:
AABA
PO Box 144
Altmar, NY 13302
|
RULES |
||
|
SALMON |
TROUT |
|
|
1ST PRIZE=20% of total ticket sales |
1ST PRIZE=20% of total ticket sales |
|
|
2ND PRIZE=15% of total ticket sales |
2ND PRIZE=15% of total ticket sales |
|
|
3RD PRIZE=10% of total ticket sales |
3RD PRIZE=10% of total ticket sales |
|
|
DAILY PRIZE FOR LARGEST FISH AT EACH CHECKING STATION |
||
|
By signing this form, I hereby hold harmless and release the Altmar/Albion Business Association, Inc. and or its agents from any liability and or damage that I may incur during the derby. I have read the rules of the 1st Annual AABA, Inc. Salmon Derby and I agree to abide by them. I agree that failure to pass a polygraph test to the satisfaction of the AABA,Inc. will result in disqualification and forfeit my entree fee. I hereby affirm under penalty of perjury that the information provided on this form is true to the best of my knowledge and belief. I understand false statements are punishable as a Class A Misdemeanor pursuant of Section 210.45 of the New York Penal Law. SIGNATURE OF ENTRANT_______________________________________________
|
||