BUCKBOARD MARINA, INC.
HCR 65 BOX 100
GREEN RIVER, WYO. 82935
(307)875-6927
You are invited to participate in the Twentieth Annual Buckboard Wyoming Classic Fish Derby. The Fishing Derby will be held June 7th and 8th 2014 at Buckboard Marina.
The entry fee will be $150.00 per team and the team may consist of no less than two and no more than four people per team and registration will be limited to 300 teams. Payout will be based on the number of actual team entries, less operating cost. A financial report will be available to participants upon request.
Boundaries of this tournament will be from the pipeline North. There will be a captains meeting on Friday June 6th 2014 at 7:00 p.m. To ensure that your team gets to participate in the Buckboard Wyoming Twentieth Annual Fishing Derby please fill out the enclosed application.
For questions or correspondence mail to Buckboard Marina HCR 65 Box 100 Green River, Wyoming 82935 or call us at (307)875-6927.
Sincerely
Les Tanner
Buckboard Marina
Under Permit By AshleyNational Forest
Buckboard Wyoming Classic
Twentieth Annual Fish Derby
Entry Form
Please Print:
Captain:______
Street______Phone#______
City______State______Zip______
Team Member:______
Street______Phone#______
City______State______Zip______
Team Member:______
Street______Phone#______
City______State______Zip______
Team Member:______
Street______Phone#______
City______State______Zip______
Boat Make______Color______
Registration # ______
Acknowledgment of Risk
I, the undersigned, recognize that there is an element of risk in any adventure, sport, or activity associated with the outdoors. I am fully cognizant of the risks and dangers inherent in fishing derby's. I certify that myself and any family members present with me, are fully capable of participating in the said activity. Therefore I assume full responsibility for personal injury to myself and/or to members of my family, or for loss or damage to my personal property and the expenses thereof as a result of my negligence or the negligence of my family participating in said activity exceptto the extent such damage or injury may be due to the negligence of others. In recognition of the above, I, the undersigned hereby release the Host organization, Buckboard Marina, the U.S. Forest Service and all other co sponsors from any responsibility for injury to me or my equipment for which I am responsible during my participation in or arising out of my traveling to and returning from this event. I further grant full permission to any broadcast, telecast, advertising, promotion or other account of this event for any purpose whatsoever.
Signed(Captain)______Date______
Team Member______Date______
Team Member______Date______
Team Member______Date______
Return This Form To: Buckboard Marina
HCR 65 Box 100
Green River, Wyo.82935
Under Permit By AshleyNational Forest
______Office Use Only
Date Received ______Entry Fee Paid$______Check-Cash ______Confirmation sent______
Date ______Team Number Assigned______