VERMONT

BASS FEDERATION

The Vermont Bass Federation will be holding its annual state team qualifier to decide the 13-man team that will represent the State of Vermont at the 2010 TBF Eastern Divisional Tournament. The host state is Massachusetts.

The STQ will be held on August 22 & 23, 2009 7:00 am to 3:00 pm, on Lake Memphremagog, Strawberry Acers State Launch This will be a draw tournament*, with a different partner each day. The combined weight for the 2 days will determine the 13-man team. To facilitate the draw* and notification of draw partners, applications and entry fees must be delivered in person or mailed with a postmark no later than August 1, 2009 to:

Frank Scalise

73 Everbreeze Drive

Colchester VT. 05446

The tournament is open to any TBF/FLW members who are also a member of a club in good standing with the Vermont Bass Federation. You must meet this condition at the time of the application. If not the application will be considered VOID and returned.

The draw will be conducted as follows: THERE WILL BE A DUAL DRAW *** see note on DUAL DRAW

Boaters and non-boaters will be drawn until either runs out. If only Boaters are left, they will be paired with each other. An odd Boater will be allowed to fish alone, and the Federation may appoint an observer to ride with them. If only non-Boaters are left, their entry fees will be refunded.

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ENTRY FORM (PLEASE PRINT):

NAME_________________________________________________________________________

ADDRESS____________________________________________________________________

CITY_______________________STATE___________ZIP CODE____________

TEL. NO._________________________________________________________________________

AFFILIATED CLUB________________________________________________________________

FLW MEMBERSHIP #_______________________________________________________________

Check appropriate boxes below:

BOATER_______ NON-BOATER_________

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I will fish only in the US ___________________________________________please sign and circle.

I will fish both Canadian and US waters __________________________please sign and circle! You will be held responsible to have all proper licenses, insurance and legal access to Canada.

Failure to produce this may result in a DQ.

LIABILITY INS.________(if boater) INCLUDES COPY OF INS. MUST INCLUDE DESCRIPTION OF BOAT, POLICY START AND END DATE, AND MINIMUM OF $100,000.00 LIABILITY.

ENTRY FEE $100.00____(NOTE: NO PAY BACK) LUNKER $ 10.00_____(NOTE: 100% PAYBACK)

(MAKE CHECKS AND MONEY ORDERS PAYABLE TO THE VERMONT BASS FEDERATION)

NOTE: ENTRY FORMS NOT PROPERLY FILLED OUT, OR NOT ACCOMPANIED BY PROPER

INSURANCE WILL BE RETURNED AND CONSIDERED VOID.

LIABILITY RELEASE: In signing this release I hereby release the Vermont Bass Federation, and its officers sponsors, from any and all damages, claims, demands, costs or expenses relating to injury of any person, or Property, which I may sustain or which I may cause by reason of participating in or in connection with this tournament.

SIGNATURE: ____________________________________________________________

*** 2 Draws will be held for the same tournament. One draw will hold boaters and non boaters fishing both Canadian and US waters. One Draw will hold boaters and non boaters that wish to fish ONLY US WATERS