2024 Volunteer Boat Captain Entry Form Volunteer Boat Captain Entry Form for MBN – YOUTH – HIGH SCHOOL October 6th, 2024 Location: Smallwood St. Park, Potomac River. Starting at 5amVolunteer Captain Name* First Last Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Boater Email* Cell Phone*Notify me of tournament information via:* Email Phone Number Boat InformationYou are responsible for providing your own boat for this tournament:Boat Year and Model*Motor Brand*Horsepower*State Boat Registration Number*Liability Confirmation* $300,000 Boating Liability Insurance ( Must email boat insurance to : Brad Ryder [email protected]} Exp. Date of Insurance*Indicate your concurrence*Having acquainted myself with the Maryland BASS Nation Tournament Official Rules (See Standing Rules document dated March 3, 2019, available at www.mdbassnation.com), I have completed this application and submitted to the Maryland BASS Nation. In signing this application, I hereby agree to be bound by, and comply with, all tournament rules and regulations. I expressly assume all risks associated with the tournament and I hereby release the Maryland BASS Nation, the host, sponsors, tournament officials and volunteers from all claims of death, injury, and/or property damage incurred by me in connection with my participation in the tournament. The use of a polygraph test will be made available and put to use if deemed necessary. Captains and Contestants are considered as being a team for the day…both must adhere to all boat and MBN tournament rules. For questions, contact the tournament director: Brad Ryder [email protected] I understand and agree to the following statements Δ
