Official Entry Form

“Shad Tournament 2010”

PO Box 907

Easton, PA 18044-0907

Name_____________________________________________________________

Street Address______________________________________________________

City_________________________ State_______ Zip Code + 4_______________

Area Code_______ Phone Number ___________________ E-mail address ____________________________

Age ______ Male______ Female_______

All registrants must be 16 years old and have a current PA or NJ fishing license.
Are you a first time entrant? [ ]Yes [ ]No
How many years have you registered? ____

Enter me in the Women’s Challenge [ ] Yes [ ] No (Women only)
Enter me in the Family Challenge ____ (Both team members are required to fill out separate forms to enter)

My check or money order in the amount of $25 for Early Bird Special (October 2009 – January 31, 2010) or $30 from February 1, 2010 thru April 23rd, 2010

entry fee is enclosed, payable to “Shad Tournament 2010”. Please do not send cash. All returned checks will be subject to a $20 service charge over and above the bank charge.

I agree to abide by all Official Rules and Regulations of the Tournament. I agree to waive any liability on the part of the principal sponsor, all other sponsors and the City of Easton in connection with the operation of the Forks of the Delaware Shad Fishing Tournament. To be eligible I understand that my registration must be received by midnight via mail or in person at Scott Park by 6pm both on Thursday April 22, 2010.

_____________________________________________________ _____________

Signature Date

Brochure registrations will available in many locations in January 20140. You may also pay in person at Easton City Hall, Recreation Department at 1 S. 3^rd Street Monday thru Friday from 8am – 4pm if you wish to pay in cash up to Wednesday, April 21, 2010.

Last day to register will be at Scott Park, Easton – Thursday April 22, 2010 from 9am – 6pm.

All hats and pins must be picked up during the Tournament dates, including Sunday of closing ceremonies. For those not able to pick up their hats & pins, registrant can include an additional $5.00 to cover shipping and handling. Hats & pins will be mailed the week of the Tournament.

** Remember ~

“Registrations & Gift Certificates are neither transferable nor are they refundable.”