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ULTIMATE ANGLER CHALLENGE SERIES
www.ultimateanglerchallenge.com
2011 Team Registration Form
Required Information:
Name 1: ______________________________________________
Street Address ______________________________________________
City, State Zip ______________________________________________
Daytime Phone ______________________________________________
Email: ______________________________________________
Signature 1: ______________________________________________
Name 2: ______________________________________________
Street Address ______________________________________________
City, State Zip ______________________________________________
Daytime Phone ______________________________________________
Email: ______________________________________________
Signature 2: ______________________________________________
PLEASE CHECK EVENTS YOU WANT TO FISH:
Ultimate Angler Bass Events:
May 14, 2011 Ely Lake, Evelth, MN. $50/team.
May 28, 2011 Island Lake Reservoir, Duluth, MN. $50/team.
June 4, 2011 Blue Lake, Nashwauk, MN. $50/team.
June 25, 2011 Pelican Lake, Brainerd, MN. $50/team.
July 23, 2011 Whitefish Chain, Brainerd, MN. $50/team.
Sept 17, 2011 Pokegama/Cross Lake, Pine City, MN. $50/team.
Annual Multispecies.com membership $25.00/yr. Required before fishing any events.
TOTAL ENCLOSED: ____________________
Payment Method: Personal check, Cashier’s Check or Money Order.
Please make write checks out to: “Doug Pirila”
This form gives permission for Multispecies.com to publish any photos or video taken for the fishing tournament(s) listed above to be used for promoting fishing as multispecies .com sees fit. These photos and/or videos can be used on the web as well. These photos and videos will be the sole property of Multispecies.com.
This form must be completed, signed and sent with your payment.
Upon registration you are acknowledging you have read the rules and will not hold the tournament, tournament anglers, or tournament officials, responsible for any injury or damage incurred during tournament activities, and I will be solely accountable for any consequences of my actions. I will to the best of my ability, adhere to the rules of the tournament, as well as be responsible for the actions of my fishing partner.
Please Return To:
Multispecies .com
Ultimate Angler Challenge Series
106 2nd Street, Proctor, MN 55810
Al @ (218) 390-5676 / Doug @ (218) 390-9973
e-mail: al@ultimateanglerchallenge.com / doug@ultimateanglerchallenge.com
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