Cowboy Church Christian Bass Club Registration Form

 

Name:________________________________________________________________________________

Address: __________________________ City:____________________ State: ____†† Zip:_______

Phone# __________________________________Cell phone # ______________________________

Date of birth: __________________††††† Shirt size: ______________

E-mail: ___________________________________________________________________

Type tow vehicle: _____________________________ License plate: ___________________________

Boat brand: _______________________†† Color: __________________TX # __________________

Trailer license plate: __________________

Partnerís Name: ___________________________________________________________________

There is a $10 registration fee. 

I understand that the Cowboy Church Bass Club is NOT responsible for accidents, injures, or even death

while participating with this club.I release the Cowboy Church Christian Bass Club of all responsibility.

Signature: ______________________________††† Date: ___________________________

Signature of parent if under 18 yrs old: ______________________________________________________

 

 

Print and mail this form to: Reggie Stewart,   P.O. Box 61,   Forreston, TX. 76041

 

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