John B. Daly Memorial
Charity Bass Classic
P.O. Box 2145
Niagara Falls, NY 14301

Ph:   434-3327
Fax: 434-2160
 [email protected]

2004 Participation Registration Form

Team Captain (1)
Name        ________________________________ (Age) ______
Address    ___________________________________________
____________________________________________________
Phone [1] _____________________   [2] ___________________
Email       ____________________________________________

Team Member (2)
Name       ____________________________________  (Age) ____

Team Member (3)
Name       ____________________________________  (Age)  ____ 

Bass Classic to Provide:
·         Captain, Boat, Fishing Equipment, Life Jackets & Bait
·         Snacks (coffee, donuts, snack packs for boat, pop)
·         Picnic
·         Fishing license (3 Day)
·         Volunteer Picnic at 3F Club – Thursday, August 5th at 6:00pm  
___ YES, I will attend Picnic. [please check this is you plan to attend]

 

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Registration Deadline:
Tuesday August 3rd.

Make Check Payable To:
John B. Daly
Charity Bass Classic

Send Registration & Payment to:
John B. Daly Memorial
Charity Bass Classic
P.O. Box 2145
Niagara Falls, NY 14301

Sponsored in part by:


and 

Donation:
Adult (21 yrs. & up)        $100.00   
Youth (16 - 20 yrs.)        $50.00   
Youth (15 yrs. & Under)  $25.00  
Adult (s) @   $100.00   _________
Youth    @    $50.00     _________
Youth    @    $25.00     _________
Total Amount Enclosed __________