KICKIN BASS CLUB

2026 Kickin Bass Membership Form / Waiver

Membership Fee- $30 per angler. After 2^nd tournament $100 per angler.

Waiver * Kickin Bass nor its affiliates will be held liable for any damage/accident/injury.

Angler #1 (Captain)  Membership Paid: $__________________

Name:__________________________________________________________________________________

Address:________________________________________________________________________________

Phone:( ____ )___________________________________________________________________________

E-mail:__________________________________________________________________________________

Signature:_______________________________________________________________________________

Angler #2               Membership Paid: $_____________________

Name:__________________________________________________________________________________

Address:________________________________________________________________________________

Phone:( ____ )___________________________________________________________________________

E-mail:__________________________________________________________________________________

Signature: _______________________________________________________________________________