Eastern Div. Stop #2 - Lake Gaston

**YOUR BOAT # WILL BE DETERMINED BY THE ORDER IN WHICH IT IS RECEIVED**
2026/27 BASS NC High School & Junior Series Eastern Div. Fall Qualifier Stop #2 @ Lake Gaston October 17, 2026

Salmon Landing Boat Ramp, 129 Salmon Landing Road, Littleton, NC 27850
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.
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)
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)
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)
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
• Chris Corriher • ccorriher1@gmail.com

NC B.A.S.S. High School (East Division) Director
• Darrel Stephenson • stephenson.darrel@gmail.com
You must download the yearly Rules and Release & Waiver by clicking the first "Download" button below. The form is to be submitted at the first tournament that you fish. The waiver will open in a different tab. Please return back to this tab after downloading to finish submitting your Entry Form.
*WAIVER MUST BE BROUGHT WITH YOU TO CHECK IN** Sign to confirm you have downloaded and read the Release & Waiver. Use finger or mouse to sign--submitting angler signature.
Should be Empty:

2026/27 BASS NC High School & Junior Series Eastern Div. Fall Qualifier Stop #2 @ Lake Gaston October 17, 2026