Michigan B.A.S.S. Chapter Federation

Junior Club Roster Form

 

Club Information
Senior Club Name
 Senior Club Number
Junior Club Name
 		Junior Club Home Town
Contact Persons Name
Phone No.
-		 Email Address
 		 
Address
City
 State
 		Zip
 		 
Junior Club Member Information
Names Address City State Zip
1.
  Date of Birth
 B.A.S.S. Number
 Email Address
2.
  Date of Birth
 B.A.S.S. Number
 Email Address
3.
  Date of Birth
 B.A.S.S. Number
 Email Address
4.
  Date of Birth
 B.A.S.S. Number
 Email Address
5.
  Date of Birth
 B.A.S.S. Number
 Email Address
6.
  Date of Birth
 B.A.S.S. Number
 Email Address
 
Thank You for Starting a Youth Club.
 
This form can be submitted electronically or printed, filled out and mailed to:
Barry Narrin, Youth Director, Post Office Box 193, Fostoria, MI 48435
989 795-3023, bnarrin@michiganbass.net
 

If you have any questions, feel free to contact one of your Youth Directors. If you have more than six Junior Bassmasters, just use more than one of these forms.