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Boat Name:

Make/Length:

Number of Engines:

Engine Make:
(I/B Diesel, I/B Gas, I/O Gas, Outboaard)

Where Will You Be Docking:

Home Port: (city,state)

Team Contact Name:

Team Contact Phone:

Is Anyone In Your Group
Staying In A Local Hotel:
(yes or no)

Is This A Charter Boat: (yes or no)

Boat Owner's Name:

Is Captain An Angler: (yes or no)

Captain's Name:

Address:

City:

State:

Zip:

Phone:

Email:

    

Fees
(Please fill in as needed - total is required)

Tournament Entry
($400)

Level 1 Calcutta
($100)

Level 2 Calcutta
($250)

Level 3 Calcutta
($500)

Level 4 Calcutta
($1,000)

Extra Banquet Tickets:
$20 x =

Limited Edition Prints:
$20 x =

Total Amount =


Mate #1 Name (Optional):
Address:
City:
State:
Zip:
Email:


Angler #1 Name (Optional):
Address:
City:
State:
Zip:
Email:


Angler #2 Name (Optional):
Address:
City:
State:
Zip:
Email:


Angler #3 Name (Optional):
Address:
City:
State:
Zip:
Email:


Angler #4 Name (Optional):
Address:
City:
State:
Zip:
Email:


Angler #5 Name (Optional):
Address:
City:
State:
Zip:
Email:


Angler #6 Name (Optional):
Address:
City:
State:
Zip:
Email:


Angler #7 Name (Optional):
Address:
City:
State:
Zip:
Email:


Notes:


Do you agree with the rules listed on the printable entry form:

I agree I disagree

  


Pay Registration Fee Online Securely Using
Any Major Credit Card!

You may also mail in your payment, the payment
information is available on the printable entry form.





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