MBN - Youth Registration MBN – YOUTH Registration Full Name* First Last Email* 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 Cell Phone*Chapter Club / School Name*What group are you registering for* Youth High School I understand and agree to the following statements* Email/Website (Preferred) Phone message Rider Only Registration PaymentMaryland Bass Nation High School Annual DuesState championship application is attached. MBN dues must be paid in order to participate. Price: Credit Card* 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: Dick Brown: 301-471-9519 / mdbfupdate2002@msn.com I understand and agree to the following Δ
