17th ANNUAL COYOTE HUNT REGISTRATION

FRI. FEB. 22 * SAT. FEB. 23 * SUN. FEB. 24, 2008

 (Office use only)

Coyote Reg. # _______________

2008 Member # ______________
Registration Fee - $10.00. Registrant must be member of Mosquito Creek Sportsmen's Association. Membership Application may accompany registration. Mail-in applications MUST be received by January 31, 2008 & MUST include Registration Fee & Self-Addressed, Stamped Envelope (SASE).

Fill in all information. Applications that are incomplete or illegible will not be processed.

First Name___________________________

Last Name___________________________

Phone # (____) _________-_____________

Mailing Address________________________________________________________________

City__________________________________ State_____________ Zip______________

Please read the following statement and verify with your signature: I have read the rules & regulations for the Coyote Hunt as set fourth by the Mosquito Creek Sportsman's Assoc., and agree to abide by these rules and regulations.

Signature:______________________________________________ Date:______________

*** Mail-ins - Remember to include Fee & SASE