September 11, 2010          Southport, NC

Captain’s Name: ____________________________________________________________

Mailing Address: ____________________________________________________________

City: ___________________________  State: ____________  Zip: ____________________

Boat Name: _______________________________________________________________

Email: ___________________________________________________________________

Waiver Contract: I understand that I as a registrant/captain/boat owner, am responsible for my boat and occupants at all times.  I hereby release the 2010 Bay Creek Classic, its sponsors, their subsidiaries, and their affiliates from any and all liability.  I further understand that the decision to fish and participate is the responsibility of the registrant/captain/boat owner. 

Captain’s Signature: ____________________________________  Date: ________________ 

• Entry Fee: Minimum $50 Donation to the Brandon Matthews Fund
• Heaviest Flounder TWT $100
• 5 Fish Aggregate TWT $50

$__________________ Total amount enclosed

 

             

              Mail check and completed entry form to:

Brandon Matthews Fund, 5069 Wyncie Wynd, Southport, NC 28461 

*Preregistrations will receive confirmation by email or mail*