21st Annual Orange Beach Spearfishing
Sept 22 - Oct 7, 2017
5th Avenue South
Birmingham, AL 35222
_________________________________ Telephone ________
____________________________ State ____ Zip ________
Affiliation __________________ Date of Birth _________
APPLICANTS MUST PROVIDE THE FOLLOWING INFORMATION
Agency and Number ______________ Years Experience _____
Registration is $70.00 (ASA Members) $80.00 (Non-ASA Members)
Includes one short sleeve t-shirt
Additional t-shirts may be purchased for $20.00
Shirt size:________ Additional Shirts___________
__ I will
be participating in the FLOUNDER winner take all JACKPOT $25.00
__ I will be participating in the SNAPPER winner take all
Total amount enclosed: $ _______ Make checks payable to: Ala.
Please enclose this form and mail with "non refundable" payment to
the address at
the top of this page. Mailed registration must be received
no later than the Safety Meeting.
I, ________________________, in
consideration of permission granted me to
in this Spearfishing Tournament to be held Sept 22-Oct 7, 2017,
do hereby agree that I will not hold any official
connected with said tournament
responsible for any accident or damage to me or my property which may occur during
said tournament. I have read, fully understand and agree to the
rules of this contest.
_____ day of _________________ 2017.
________________________ Witness _______________________
Signature of parent or guardian if under 21 years of age.