BIG-GAME HUNT TOURNAMENT
NOVEMBER 26 & 27, 2010

REGISTRATION FORM
(This form may be duplicated)


Please check the appropriate box and completely fill out the entire registration form.
   Big-Game Hunt
  Youth Division (Ages 10-15)


Name ___________________________________________________________

Address _________________________________________________________

City, State, Zip __________________________________________________

Home Phone # __________________ Work Phone # ___________________

Hunter Education Course # (for youths ages 12-15 only) __________________________

     I, as an entrant in the Big-Game Hunt Tournament, do hereby release, discharge and hold harmless the Big-Game Hunt Committee, the Anson County Chamber of Commerce and its officers and directors, sponsors and agents, whether individual or corporate, from any claim to damages to my person or property incurred by my participation in the tournament. By signing the registration form and paying the entry fee, I acknowledge that I have read this release and am bound by the same. This release shall also be binding on my heirs, executors, administrators or assignees.
     I have read and understand the Big-Game Hunt Tournament rules and will abide by the rules and regulations of the North Carolina Wildlife Resources Commission.

Signature (Required) ___________________________________________

Date __________________________________

RETURN