LIMITED TO THE FIRST 60 PAID TEAMS PER EVENT

1. Having read the Official FBFP2012 Northern Open Anglers Association Rules and completed the below entry form and paid the $215 per event and an annual one time $45 per member organizational fee, I/we agree to abide by all conditions, and accept penalties determined by officials, stated therein. (rev12.08.11)

2. Liability Release: By signing this agreement, I/we hereby release the State of Ohio, FBFP 2012, Rory Franks and any officer’s, agents, official’s, employees and sponsors thereof from any and all damages, claims, costs or expenses relating to injury or even death, of any persons or property, which we may sustain or cause by reason of our participation in or in connection with this tournament. I/We further authorize the use of any images or likeness of our person and name(s).

3. I/We have received and read a copy of the official 2012 Northern Open Anglers Association Rules and understand our agreements as outlined in items 1 and 2 above.

NAME:__________________________________ ADDRESS:________________________________ CITY____________________STATE/ZIP___________ EMAIL____________________________________

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NAME:__________________________________ ADDRESS:________________________________ CITY____________________STATE/ZIP___________ EMAIL____________________________________

PHONE____________________________

X_____________________DATE: _____

*2012 ANNUAL PER MEMBER ORGANIZATIONAL FEE ($45 each) ___*

MOSQ4/21($215)___ BERLIN6/09($215)___ MOSQ7/14($215)___ BERLIN8/11($215)___ *NY SUPER*8/26($215)___

Entries postmarked/paid the Monday prior to each event, up to tournament day incur a $20 late fee (TOTAL $235). Prepays must pay in check or money order PLEASE DO NOT MAIL CASH! BOUNCED CHECK FEES ARE $50. Complete forms and mail to:

NOAA (make checks payable to FBFP 2012)

3079 SUMMIT RD., RAVENNA, OH 44266-9048