National Qualifier Entry Form

1st Partner Name Address City, State, Zip Phone No. E-Mail Signature 2nd Partner Name Address City, State, Zip Phone No. E-Mail Signature 3rd Partner Must be 15 or Under; 65 or Older Name Address City, State, Zip Phone No. E-Mail Signature

Instructions:Print this form and check off the lakes you wish to fish. Total each and enter in the spaces provided below. Please check all the appropriate spaces, multiply out and remit payment (check or money order) or complete the credit card section of this entry form. Tournament Location Date $25.00 Late Fee if Postmarked after this date Lakes Marion & Moultrie, SC 02/19/05 02/04/05 West Point Lake, GA 04/09/05 03/25/05 Mississippi River, IL 04/30/05 04/15/05 Missouri River, KS 05/14/05 04/29/05 Mississippi River, MO 05/28/05 05/13/05 Milford Lake, KS 06/18/05 06/03/05 Mosquito Lake, OH 06/25/05 06/10/05 Missouri River, MO (at Night) 07/30/05 07/15/05 Ohio River, IN 08/13/05 07/29/05 Mississippi River, MO 08/20/05 08/05/05 Mississippi River, MO 10/22/05 10/07/05 Cabela's Classic Lakes Marion & Moultrie Sep.9-10, 2005 Classic Qualifiers will recieve R.S.V.P. form by mail I(we) by signing hereby release Outdoor Promotions, Inc., King Kat Trail and all participating sponsors of this tournament from any loss of property, bodily injury, or loss of life that may occur in this tournament. I understand that selected contestants must take and PASS A POLYGRAPH or VOICE STRESS TEST to qualify for the receipt of any prize and in order to verify compliance with all tournament rules. Only one test per claim will be given. I release Outdoor Promotions, Inc., King Kat Trail and all participating sponsors from any liability resulting from the decision of the examiner, agree that the decision of the examiner is final, and agree to abide by the decision of the examiner. I agree that any mention of my name or photographic likeness may be used by King Kat for promotional purposes. Entry Fees Per Team $150.00 X No. of Events Entered     $_________ $250.00 Cabela's KingKat Classic     $_________ Late Fee: $25.00 X No. of Events     $_________ TOTAL DUE:     $_________

Send completed entry form to: Cabela's King Kat Tournament Trail P.O. Box 2232, Brentwood, TN 37024-2232 •Phone: (270) 395-6774    •Fax: (270) 395-4381

CHARGE TO MY       CREDIT CARD  VISA  MASTERCARD Signature: ____________________________________________ OFFICE USE ONLY:  Total Paid:______ Cash______ Check #______