Broadwater Rod and Gun Club Tournament
Entry Form
The Broadwater Rod & Gun Club Walleye Derby will be held on July 17, 2010 from 8:30 AM to 2:30 PM on Canyon Ferry out of Goose Bay.

This tournament is limited to 90 two-person teams with a $1,000 first prize based on a full field. Each of the three team categories will have cash prizes. Three catagories of two-person teams will compete-- female/female, male/female and adult/child(17 & under). Contestants may have four people in the boat, but only two fishing. The tournament will be a catch and release format, but one fish per entrant can be kept as a trophy. A mandatory pre-tournament rules meeting will be held at 7:00 PM on July 16, 2010 at the Broadwater Rod & Gun Club indoor shooting range on Canton Lane one mile north east of Townsend. For more infomation contact Doug Breker at 266-5279 (work) or 266-3102 (home) before 8:30 p.m. Or e-mail him at te@townsendelectric.com.

Entries are expected to fill quickly, so mail in your entry forms as quickly as possible. To enter the tournament, just print out this form, fill it in, sign it, mail the form and your $80 (make checks out to Broadwater Rod & Gun Walleye Derby) per two-person team to: Broadwater Rod & Gun Club Tournament, P.O. Box 641, Townsend, Mt 59644.

FIRST TEAM MEMBER: ____________________________________________________________

ADDRESS: ___________________________________________________________________

CITY, STATE, ZIP CODE+4-DIGIT_________________________________________________

Age: ___________ Male:____________ Female:___________

HOME PHONE: (_______)___________________  CELL PHONE: (_______)___________________

E-MAIL: _____________________________________

Angler ID# (Please use your MFWP- ALS# which can be found on your fishing license)_________________________


FIRST TEAM MEMBER'S SIGNATURE:_______________________________ DATE: _______________

SECOND TEAM MEMBER:___________________________________________________________

ADDRESS: ___________________________________________________________________

CITY, STATE, ZIP CODE+4-DIGIT_________________________________________________

Age: ___________ Male:____________ Female:___________

HOME PHONE: (_______)___________________  CELL PHONE: (_______)___________________

E-MAIL: _____________________________________

Angler ID# (Please use your MFWP- ALS# which can be found on your fishing license)_________________________

SECOND TEAM MEMBER'S SIGNATURE:_______________________________ DATE: _______________

ADULT/CHILD TEAM ENTRY ___________ MALE/FEMALE TEAM ENTRY _____________

FEMALE/FEMALE TEAM ENTRY ___________