United States Fishing Association, Inc.
TEAM WALLEYE
OFFICIAL ENTRY FORM
Team Captain_________________________________
Social Security#_______________________________
Address______________________________________
City/State/Zip__________________________________
Daytime Phone_________________________________
PLEASE COMPLETE PARTNER INFORMATION
Partner_____________________________________
Social Security #______________________________
Liability release
Signature_________________________________________
Signature_________________________________________
Parent or Guardian Signature if under 18_____________________________
ENTRY FEE: Team Walleye 1-day $115/2-day $125
Tournament Date and location: Saturday, March 25th at Moundwood Ramp Indian Lake, Ohio
Payment:
Check/Money Order____    Charge - MasterCard/VISA/AmEx____
Card # _______________________ Exp. Date________
(5% bank fee will be added to charges for entry fees only)

Signature_________________________________
Make checks payable and mail to:
USFA
P.O. Box 118228
Carrolton, TX 75011-8228 or call (214) 390-1906   FAX 214-390-1926
This form supplied by the Indian Lake website - www.indianlake.com