20223Entry Forms

                                       Please Print & Return to
                                 Anglers Quest by regular mail at
                                23855 Stanart Rd. Porter, Tx 77365
              or phone 281-852-8842 / 281-577-7855 with Credit Card

 
                                    EACH ANGLER MUST PAY

                                      A ONE TIME $40.00 FEE

                     

                                        Individual Series

Date______ Houston=$100.00 per entry/with cc +3.75% per entry

 

                                     Team Series

Date______ Houston=$200.00 per team/with cc +3.75% per team


Date______
Livingston=$150.00 per team/with cc +3.75% per team


Date______Conroe
=$200.00 per team/with cc +3.75% per team

   

 

                                     

Partner #1:

Name: ____________________________________________________


Address
: __________________________________________________


City:
_____________________________________________________


State & Zip
: ____________________________________________________


Phone
: ___________________________________________________


SSN#
: ____________________________________________________

             
            E-Mail
: ____________________________________________________             

Lodging during event: _______________________________________

Partner #2:


Name
: ____________________________________________________


Address
: __________________________________________________


City
: _____________________________________________________


State & Zip
: ____________________________________________________


Phone
: ___________________________________________________


SSN#
: ____________________________________________________


E-Mail
: ___________________________________________________


Boat Information:


Boat Brand & Length
: _________________________________________________


Engine Make & HP
: _________________________________________________

Payment Information:
Additional 3.75% handling fee for credit card charges


Method of Payment
: __________________________________________


____
Check  ___ Credit Card on file  ____ Call Office @ 281-852-8842 or mail to:


Anglers Quest 23855
 Stanart Rd. Porter, Tx 77365

 

RELEASE & WAIVER


In return for being allowed to participate in this contest, I expressly release and agree to hold harmless the sponsors, officers, employees, agents and affiliates from any and all claims as result of personal injury, property damages, accidents or illnesses (including claims caused in whole or in part by the negligence of the sponsor) that I may suffer which may arise during the course of or in connection with this Tournament. I further expressly assume the risk of any personal injury, property damages, or any other damages of any nature, which I may sustain in connection with my participation in this contest. I also release to A/Q the use and reproduction of any and all photographs and pictures taken during this event. I have read and understand the rules regulating this tournament. I also understand that cheating in this tournament is a punishable felony under current State statutes. Sponsors are defined as Anglers Quest, and any others supporting this event.

Signature 1: _________________________________________________________________
																				Signature 2: _________________________________________________________________
				

 

 

Please Print this Entry Form and
Mail Entries & Checks to:
ANGLERS QUEST
23855 Stanart Rd.
Porter,Tx 77365
PH. 281-852-8842 or 281-577-7855

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