Electronic Release Form

 

Pomme de Terre Chapter Of Muskies Inc. Release Form, Electronic
Membership Number  
Expiration Date        
Name  
Address  
City  
State  
Zip Code 
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 Lake  
Hours Fishing Since Last Legal Muskie  
Hours Since Last Muskie  
Time Caught   AM  PM
Sky Conditions  
Presentation  
Bottom  
Structure  
Wind Speed  
Wind Direction  
Division  
Juniors Members Age  Birthday 
Muskie Was  
Check The Box If You Want:  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 International Awards

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

Anything Unusual About This Muskie, Where You Caught It?