1. 6th Annual Tiffany Thomas Memorial Fishing Tournament
Registration Form
NAME: _______________________________________
STREET: _____________________________________
CITY: _________________ ZIP: ___________________
SEX: ________ AGE: _______ T-SHIRT SIZE: ______
PHONE: ______________________________________
SIGNATURE: _________________________________
_________________________________________
________________________________________
In signing this application, I hereby waive and release all other contestants, the hosts, sponsors and tournament officials from all claims of injury and/or damage incurred in connection with this tournament. I have become familiar with and agree to abide by the tournament rules as they are posted on the Tiffany Thomas Memorial Foundation website. Furthermore, I understand that all winners are subject to polygraph testing. I further understand that refusal to take the polygraph or failure of the polygraph will result in forfeiture of awarded cash and prizes. I swear that the above facts are true to the best of my knowledge, and enclose herewith my application fee.
***Please provide information if available so that we may send you newsletters with updates regarding the Foundation and tournament.
Entry Fee: $ per boat
Please make checks payable to:
Tiffany Thomas Memorial Foundation
51005 Hwy. 445
Loranger, LA 70446
Entry Deadline: April 18, 2015, 6:30 a.m.