Youth and High School Captain Volunteer Registration Form

Volunteer Boat Captain Entry Form for MBN – YOUTH – HIGH SCHOOL
October 6th, 2024
Location: Smallwood St. Park, Potomac River. Starting at 5am

Volunteer Captain Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Boater Email*

Cell Phone*

Notify me of tournament information via:*

Email
Phone Number

Boat Information

You 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

2024 Volunteer Boat Captain Entry Form

Boat Information

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