Name ___________________________________________ Age____________
Signature _________________________________________Date ___________
Address _________________________________________________________
City/State_________________________________________ Zip____________
Phone Number_______________________________________________________ E-mail ______________________________________________
Check Applicable Tournament options enter whichever ones you want
□ Merchandise Prize Category $25.
1st to 18th for bass and 1st -18th for blues
□ Cash for Bass Category - 1st to 3rd place
$25.
□ Big Gun’s Cash for Bass Category - 1st to 3rd place $50.
□ Cash for Blues Category - 1st to 3rd place $25.
□ Big Gun’s Cash for Blues Category - 1st to 3rd place
$50.
Total Enclosed:
Make check to Berkeley Striper Club, mail to:
160 Doherty Dr., Clifton, N.J. 07013
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