Official
Entry Form
2nd Annual Kids
Fishing Derby
May 4th 2011
Mail entry form to: Anna Point Marina
13721 Anna Point Lane
Mineral, Va. 23117
Fax: 540-895-9350
E-mail: info@annapoint.com
We will have a Registration table set up for those who want to register the morning of the tournament. The cut off time is 9:30 am.
Entry Fee: $20 each Contestant (Lunches will be provided). We understand that the entry fee of $20 is refundable only in the event that we are unable to participate and notify tournament officials prior to 8:00 am on the day of the tournament. Prizes will be awarded for 1st, 2nd and 3rd Place in each Division and each Category. 1 Grand Champion Trophy will be given to the over all largest Fish of the Tournament. Divisions are 6 - 9 Years / 10 - 12 Years / 13-15 Years. Categories are Bass, Catfish, Crappie and Sunfish. The Kids can fish with Parents or Responsible adult from the shore or a boat.
( Please
Print !! )
PAID REGISTRATION ( )
NAME________________________________________________________________
Age:___________
For
Office Use
Division
6 to 9 year ( )
Division
10 to 12 year ( )
Division
13 to 15 Year ( )
We the undersigned, are enclosing the entry fee payable to Anna Point Marina, LLC. We hereby waive and release Anna Point Marina, LLC and it's employees and other entrants of all claims of personal injury or property damages incurred during the activities of this event for which this application is being submitted. We sign that the above information is true.
Responsible Adult Signature:____________________________________________________________________