October 21-22 at Ross Barnett, Mississippi
Official Media Bass Team Championship 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


Tournament Options

Cost

Team Championship Package - $220
Includes T-Shirts, Caps, Koozies, Decals, and Weigh Bag also:
and B.A.S.S. Team Championship Membership
Shirt Size #1 Shirt Size #2
S M L S M L
XL XXL XXXL XL XXL XXXL
$2 Extra for XXL and $3 Extra for XXXL sizes

Your Total Is:

Entry must be received by Monday before Tournament for exact T-Shirt size

Make Checks Payable to: Media Bass
Mail This Entry Form To:
Media Bass
3309 Riverview
Mesquite, TX 75181

Phone: 972-222-2207
Email

All Entry Fees Include Daily Big Bass Pot
Team Championship Fees
Championship Package = $220


Official Media Bass Championship Entry Form (Enter With Credit Card)

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