Electronic Release Form

Pomme de Terre Chapter Of Muskies, Inc. Electronic Release Form

Membership Number
Expiration Date
Name
Address
CityStateZip
Lake/River
County
State/Prov
Lure Name
Lure Type
Primary Color
Secondary Color
Muskie Length
Muskie Girth
Date Caught
Depth Of Muskie When Caught
Depth Of Water
Hours Fishing Since Last Legal Muskie
Hours Since Last Muskie
Time Caught Round Up/Down AM/PM
Sky Conditions
Presentation
Bottom
Structure
Wind Speed
Wind Direction
Division
Junior Members AgeJunior's Birth Date
Muskie Was
Check The Box If You Want A
Release Patch Individual Certificate Yearly Certificate

Check Here if you want your name withheld from Muskies, Inc. Publications, the MI Website and consideration for all MI Awards

I swear and affirm that I have complied with all the rules on this form, and that all the information to the best of my knowledge is true, accurate and complete.  I consent to the use of and/or all information in Muskies, Inc. research studies or publications, including the internet website.
(Typing your name is the same as signing your signature)
Name
Date
Email Address
Witness Name
Witness Phone Number

Anything Unusual About This Muskie, Where You Caught It?