Ebass 2021 Day Entry Form

    Event Date
    Event Dam
    Team Name
    Skipper Name
    Skipper Phone Number
    Skipper Email
    Skipper Physical Address
    Co-angler Name
    Co-angler Phone Number
    Co-angler Email
    Co-Angler Physical Address
    Bank Name
    Bank Account Holder
    Bank Account Number
    Branch Code

    I hereby confirm that I have read and understand the Indemnity(Details on this website). I further agree to subject myself to the terms and conditions set out there in.