City, State Zip |
NC Open Gold Panning Competition ENTRY FORM |
$ |
Donation Enclosed |
$ |
Waiver: In consideration of the acceptance of the entry, I agree to abide by the rules of this competition and agree to accept the decision of the judges as final. I also give permission for the use of my name and photograph in any broadcast or account of this event for any legitimate purpose. |
E-mail |
Parent’s Signature if under age 18 |