Participation and Waiver Agreement

HS/Jr/BC || PWA - Participation and Waiver Agreement

I understand I must sign and date this agreement prior to participating in Georgia BASS Nation Youth Inc.; herein referred to as GBN, tournament event, and that if I am under the age of majority in the state in which I reside, I must obtain the consent, and the signature of a parent or guardian to enter into this agreement. My registration is not complete until GBN acknowledges receipt of, and the acceptance of this agreement, and receives the consent of my parent or guardian (if applicable), and all other necessary documents. The GBN Tournament Director or GBN Board of Directors, reserves the right to deny my participation in the tournament series or any component thereof for any reason and, upon such denial, to refund the deposit or entry fee.

PLEASE select the correct GBN affiliation below. Errors in selection will cause delays in processing.

GBN HS/Jr Student Angler: GBN HS/Jr anglers participating in the GBN HS/Jr tournament trail

GBN HS/Jr Boat Captain: HS/Jr Boat Captains participating in the GBN HS/Jr tournament trail.
Affiliation:*

GBN HS/Jr Student AnglerGBN HS/Jr Boat Captain
**NOTE: As of Sept 1, 2024, GBN requires ALL HS/Jr anglers age 13 and up, show proof of a completed Boater Safety course.

**NOTE: (i) Students must belong to the same official high school/junior school club or official community club within the county of residence to compete as a team in a GBN HS/Jr tournament.

In the event a student angler cannot be paired with a partner from the official high school/junior school or community club, the student angler may be allowed to pair with another partner based on the discretion of the GBN Board.

(ii) Community clubs can incorporate multiple institutions to include home school students. Students from those institutions must all be members of the same community club.

(iii) High School/Junior students must participate for the school which they would normally attend.

a. If the school does not allow Home School Students to participate in sports, then they will fish for the next nearest school or community club who does, but only after receiving written acknowledgement from their school system declining homeschool students access to sports programs.

Any/All pairings of student anglers outside the above stated rule(s) or pairing across state lines must have written recommendation / acknowledgement of both Official High School/Junior School or Community Club Coaches and both State Youth Directors approval from B.A.S.S.

GA Bass Nation HS and B.A.S.S. High School reserves the right to accept or deny such a request.
Is the PWA for a High School Angler or Jr School Angler?*

HSJr
School Name ONLY: Name of the school the angler attends; must be in the state of Georgia, IF NOT please contact GBN. PLEASE DO NOT use fishing team or club name at the school. SEE GBN HS/Jr Participation/Eligibility rules.*
Enter active school name
Select the GA county in which the school attended by the angler above is located.*
Select GA county

Name*

First NameLast Name
Address*

Address

Street Address Line 2

CityState

Zip Code
Cel/Mobile Phone # (If the PWA is for HS/Jr angler, the use of parent/guardian cell is allowed if needed)*
Valid cell phone
Enter a valid email address (If the PWA is for HS/Jr angler, the use of parent/guardian email is allowed if needed). Please verify (same email in both fields):*

Confirmation Emailconfirm email
BC: Enter name of your HS/Jr Angler#1*

First NameLast Name
BC: Enter name of your HS/Jr Angler#2*

First NameLast Name
**OPTION** HS/Jr Boat Captain: Enter email address of your team's individual or representative that is registering the team via the on-line entry form. This will ensure the individual gets a copy of this submission (PWA) containing the SUBMISSION ID which is required for on-line entry. (example@example.com) DO NOT reenter your own email address.
**OPTION** HS/Jr Angler: Enter email address of individual or representative registering your team. This will ensure the individual gets a copy of this (PWA) SUBMISSION ID which is required for on-line entry. (example@example.com). DO NOT reenter your own email address.
REQUIRED to be an active member of BASS.

Membership number can be found:
BASS (parent org) membership number:*
BASS membership number

Boat Captain: Are you using a borrowed boat?*

NO - I am the registered owner of the boatYES - I am using a borrowed boat
Boat Captain: **NOTE: IF using a borrowed boat, the "Borrowed Boat: Permission to use" form is REQUIRED. After submission of "Borrowed Boat: Permission to use" enter the form submission ID below.*
Borrowed Boat submission ID

BC: GDNR or valid state boat registration #*
HULL Registration number
BC: Make/Model/color of boat*
Ex: Ranger/520/red
BC: Make/HP motor*
Ex: Mercury/250

** BOAT CAPTAINS **

(1) GBN requires; as of July 1, 2024, all Boat Captains that operate or could operate a combustible engine powered vessel in a GBN HS/Jr tournament, to show completion of an approved National Association of State Boating Law Administrators (NASBLA) boater safety course OR a copy of a certified Coast Guard Captain's license.

PLEASE use the space below to upload a copy of your approved Boater Safety Course completion or Coast Guard Captain's License. This space will accept various file types including pdf, doc, docx, txt, rtf, html, jpg, jpeg, png, gif.

Normally completion certificates are or can be printed as pdf type file.
Boat Captains: Boater Safety Course: ** REQUIRED to provide proof, please upload a copy of completion. *

Boater Safety Course
Cancelof

Is the HS/Jr angler age 13 or over? ** As of Sept 1, 2024, ALL GBN HS/Jr anglers age 13 and up are REQUIRED to provide proof of Boater Safety Course*

YesNo
Boater Safety Course: please upload a copy of completion. *

Boater Safety Course
Cancelof

Is the person for which this PWA is entitled or executed a MINOR? (Georgia Code Title 39. Minors § 39-1-1:The age of legal majority in the state of Georgia is 18 years; until that age all persons are minors.)*

YESNO

THE FOLLOWING SECTION MUST BE COMPLETED BY MINOR'S PARENT OR LEGAL GUARDIAN:

I attest that I am a parent or legal guardian of the minor who this PWA is entitled or executed for, and I hereby consent to the terms of set forth herein and agree that we both shall be bound thereby.

I have read and have understood the provisions of this agreement contained in the "PWA - Participation and Waiver Agreement Information" document, and the official Tournament Rules. Both documents are available for download at [georgiabassnation.com/Forms&Docs]

I understand that by signing this agreement, which contains liability and other release language, I have given up substantial rights. I have voluntarily signed this agreement.
Parent/Guardian*

First NameLast Name
Check below to fill in address, cell phone and email from entry info. EDIT if necessary.

YES, use fill in
Address*

Address

Street Address Line 2

CityState

Zip Code
Parent/Guardian - Cell Phone #*
Valid cell phone
Parent/Guardian - Enter Email address and verify (same email in both fields):*

Confirmation Emailconfirm email
Terms and Conditions*
Parent or Legal Guardian Signature*

Clear

Terms and Conditions*
Signature*

Clear

GBN reserves the right to accept or deny any entry form submitted.

You will receive a confirmation email of your submission along with a SUBMISSION ID.
Please verify the CAPTCHA and SUBMIT*
Should be Empty: