KICKERFISH BASS SERIES Registration Form

Name:*

First

Last

Mailing address:*

Street AddressCityProvince/StatePostal / Zip Code

E-mail address:*

Shirt size: M/L/XL/2XL/3XL*

$50 (fifty) Series entry fee. Check one:*

Interac e-transfer

In Person

By agreeing, I acknowledge that my name, likeness, and performance in connection with the Kickerfish Bass Series and/or its partnered events may be used to promote, publicize, or otherwise report on the results. I acknowledge that I have read the rules of the KBS and fully understand them. I acknowledge that the KBS is not liable for any death, injury, damage, fire, theft or loss that may result prior to, during or after the partnered tournaments howsoever caused.*

I agree

If paying by:

Interac e-transfer – email payment to kickerfish.ca@gmail.com (add full name and transaction password with email message)

In Person – call or text Eric at 204-995-6583 to arrange