Spring Qualifier - High Rock Lake, April 6, 2025

**YOUR BOAT # WILL BE DETERMINED BY THE ORDER IN WHICH IT IS RECEIVED**
2025 BASS NC High School & Junior Series Spring Qualifier @ High Rock Lake - April 6, 2025

Southmont Boat Ramp, 899 Wildlife Recreation Area Access Rd, Lexington, NC
Check the Category in which this entry form applies to: (See “Rule #6 – Entry Fees” for a definition of each category shown below.) Bring CASH payment to check-in the morning of tournament.

High School Division - $40 Per TeamJunior (Middle School) Series - $20 Per Team
Youth Angler #1
Nation Team Name or Club Name
Angler Name

First NameLast Name
BASS Membership #
Current School Grade
Contact Email
example@example.com
Emergency Contact Name

First NameLast Name
Emergency Contact Phone

Area CodePhone Number
Parent / Legal Guardian

First NameLast Name
Parent / Legal Guardian Signature - By signing this form I acknowledge I have reviewed the rules and rules revisions (found in the link below) with my Angler, and we understand and agree to all rules. (use finger or mouse to sign)

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Youth Angler #2
Angler Name

First NameLast Name
BASS Membership #
Current School Grade
Contact Email
example@example.com
Emergency Contact Name

First NameLast Name
Emergency Contact Phone

Area CodePhone Number
Parent / Legal Guardian

First NameLast Name
Parent / Legal Guardian Signature - By signing this form I acknowledge I have reviewed the rules and rules revisions (found in the link below) with my Angler, and we understand and agree to all changes (use finger or mouse to sign)

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Boat Captain Information
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone

Area CodePhone Number
Mobile

Area CodePhone Number
Boat Information

Boat BrandHorsepower
Boat Captain Signature (IF YOUR CAP'T IS NOT PRESENT, HAVE HIM/HER SUBMIT A SEPARATE FORM OR SIGN IN PERSON ON TOURNAMENT MORNING. THANK YOU)

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Before You Sign!!! Important reminder of the minimum required liability insurance (See rules)

By signing this application all members submit that we have read and understand the rules as required for the NC B.A.S.S. High School Series as required per event) and furthermore agree to waive and release B.A.S.S., NC B.A.S.S. Nation tournament officials, and event sponsors of any claims of personal injury or property damage while participating in this event.
Contact Information:

NC B.A.S.S. Nation Youth Director
• Bob Bauer • bbauer42@yahoo.com

NC B.A.S.S. High School (West Division) Director
• Chris Corriher • ccorriher1@gmail.com
You must download the yearly Rules and Release & Waiver by clicking the "Download" button below. The waiver will open in a different tab. Please print the waiver, fill out, sign, and return back to this page after downloading - to finish submitting your Entry Form. The signed form needs to be turned in at the first tournament you fish each season. The waiver only needs to be turned in once each tournament season - which begins in the Fall.
*WAIVER MUST BE BROUGHT WITH YOU TO CHECK IN** Sign to confirm you have read the rules, the Release & Waiver. Use finger or mouse to sign--submitting angler signature.*

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Should be Empty:

2025 BASS NC High School & Junior Series Spring Qualifier @ High Rock Lake - April 6, 2025