Tournament Location: Banks Lake
Date: July 17th & 18th, 2010
Registration fee is $100.00 per Jack & Jill team if received by June 20th, 2010.  There is an 80% payback and 10% will be donated to Seattle Children's
Hospital.  You are permitted to register on the morning of the tournament July 17th (6 - 7am): however there is a $10.00 late fee for all entries not received
by June 20th, 2010.  Teams must consist of one Jack & one Jill, and the boater must be an adult.  Each team member must fish during the tournament.  
Tournament waters are off limits from July 12th to the 16th, 2010.  The Tournament Headquarters will be at Coulee Playland Resort and space is limited
so get your registration in early.
Northend Bass Club and Blue Flame Heating & Air-conditioning
2010 Jack & Jill Open & Spaghetti Feed Registration Form
Date (dd/mm/2010)
 Boat Make
 Boat #
 Horsepower
Boater, Name
 Non-Boater, Name
check one
 check one
Male
 Female
 Minor?
 Male
 Female
 Minor?
Phone #
Phone #
E-Mail
E-Mail
Non-Boater's
Address
Boater's
Address
Entry Fee:                      $100/Jack & Jill Team
Total Payment Amount:
Entry Fee after 6/20/2010:         $110/Jack & Jill Team
Jack & Jill Big Fish & Spaghetti Feed (included)
You now have two registration options: 1. Click submit and then mail your personal check separately to the address below; please write "on-line
registration" on your check, or 2. Print this form and send it, with your payment, to the address below.  If you decide on option one your entry will be
designated unconfirmed until your payment has been received.  Important: an unconfirmed registration does not guarantee a place in the tournament.
 Once your payment has been received your entry will be confirmed and your place in the tournament has been saved.   
For information call:        Charlie Cox (206) 708-1531, Mel or Debra Marchese
                                      (425) 238-9506, or (360) 691-0460
       E-Mail:                   administrator@northendbass.com               
Mailing Address:     Northend Bass Club
                              P.O. Box 570, Granite Falls, WA 98252  
Tournament Regulations:       All tournament regulations will follow TBF and WSBF tournament guidelines.  Any additional tournament requirements
will be discussed at the driver's meeting at, 7am, July 17th, 2010.
PLEASE READ CAREFULLY
I have completed this application and will be submitting in full the fees needed for participation in the Northend Bass Club and Blue Flame Heating and
Air-conditioning 2010 Jack & Jill Open.  I understand I do not have a position in the bass tournament until my fee has been collected by the Northend
Bass Club.  I further acknowledge that by checking the "ACCEPT" box below will serve as sufficient proof of my acceptance of all liability for any and
all injuries and/or damages incurred in connection with this event.  I understand by filling in my name where provided and then submitting this form via
the Internet will serve as proof of my release of all tournament officials and sponsoring organizations from all claims of injury and or damages incurred in
connection with this event. I understand that Northend Bass Club and Blue Flame Heating and Air-conditioning reserve the right to refuse entry and
services to anyone we see fit.  I also understand that by signing this entry form and mailing it to Northend Bass Club will equally serve as proof of my
acceptance of all liability as listed above.
Boater Signature
 Non-Boater Signature
ACCEPT
Date
 Date
*For those mailing their entry form please make sure you sign where indicated before putting
it in the mail. For those where the Non-Boater is a minor the bottom portion of this form
needs to be included with payment signed by the minor's parent or legal guardian to be able to
fish in the Jack & Jill Open.
Guardian Release Signature
Date
CLICK HERE TO PRINT
A PRINTER FRIENDLY
FORM