Official Media Bass Texas 'Super Teams' Entry Form (Enter With Credit Card)
Angler 1

Birthdate    
Address
City
State Zip
Phone
SSN
Email
Angler 2

Birthdate    
Address
City
State Zip
Phone
SSN
Email

Team Name (i.e. Bass Chasers or Business Name)
Team Website Address

Select All That Apply:

January 30 at Sam Rayburn = $320 (includes Big Bass)

March 27 at Lake Fork = $320 (includes Big Bass)

May 22 at Sam Rayburn = $320 (includes Big Bass)

July 24 at Toledo Bend = $320 (includes Big Bass)

Your Total Is:

Mail This Entry Form To:
Media Bass
3309 Riverview
Mesquite, TX 75181

Phone: 972-222-2207
Email

 Entry Fee = $320 per team

Official Media Bass Texas 'Super Teams' Entry Form

Full entry fee may be transferred to another tournament of same division if notified three days prior to tournament.

MediaBass.com - 3309 Riverview - Mesquite, Texas 75181
(972)222-2207