Official Media Bass Texoma Teams Entry Form
Angler 1

Birthdate    
Address
City
State Zip
Phone
SSN
Email
Angler 2

Birthdate    
Address
City
State Zip
Phone
SSN
Email
Select All That Apply:
Tournament #1 - Big Bass Option
Tournament #2 - Big Bass Option
Tournament #3 - Big Bass Option
Tournament #4 - Big Bass Option
Tournament #5 - Big Bass Option
Tournament #6 - Big Bass Option
Angler 1 Membership
Angler 2 Membership

Your Total Is:

Mail This Entry Form To:
Ben Shaffer
28 Elm
Pottsboro, TX 75076

Phone: 903-271-7156 or 214-324-2554

Entry Fee = $150 per team
Big Bass Option = $10 per team
Membership Fee = $30 per person
Membership is good for all 2008 season events