2010 St. Coleman Men's Club Walk on Water Fishing Tournament Official Entry Form

 

Early entry fee for forms and payment received prior to midnight July 23, 2010 is $200 per vessel (up to four anglers). Entry fee for forms and payment received after July 23, 2010 is $225 per vessel (up to four anglers).

 

Entry fee includes: Captains Bag, official tee-shirts for up to four anglers, and entry to the Awards Banquet Dinner. Additional anglers: $20 each (includes tee-shirt and Awards Banquet Dinner). Additional Awards Banquet Dinner: $10.00 each.

 

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Anglers:

 

Angler 1 name:

 

Angler 1 e mail:

 

Address (street, city, state zip):

 

Angler 1 Florida fishing license number:

 

Angler 1 tee shirt size: Choose Option Large Extra Large Extra extra large

 

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Angler 2 name:

 

Angler 2 e mail:

 

Address (street, city, state zip):

 

Angler 2 Florida fishing license number:

 

Angler 2 tee shirt size: Choose Option Large Extra Large Extra extra large

 

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Angler 3 name:

 

Angler 3 e mail:

 

Address (street, city, state zip):

 

Angler 3 Florida fishing license number:

 

Angler 3 tee shirt size: Choose Option Large Extra Large Extra extra large

 

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Angler 4 name:

 

Angler 4 e mail:

 

Address (street, city, state zip):

 

Angler 4 Florida fishing license number:

 

Angler 4 tee shirt size: Choose Option Large Extra Large Extra extra large

 

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Vessel:

 

Boat name:

 

Make and length:

 

Captain's name:

 

Captain's phone:

 

Captain's address (street, city, state, zip:

 

Additional anglers:

 

Additional anglers incur a charge of $20 each, including tee shirt and awards dinner. All anglers must sign entry form. Please provide complete information on additional anglers on a separate sheet.

 

Number of additional anglers: Choose Option 1 2 3 4 5 6

 

Additional tee shirts:

 

Additional tee shirts cost $10 each.

 

Number of large additional shirts: Choose Option 1 2 3 4 5 6

 

Number of extra large addional shirts: Choose Option 1 2 3 4 5 6

 

Number of extra extra large additional shirts: Choose Option 1 2 3 4 5 6

 

Additional awards banquet dinners:

 

Each additional dinner costs $10. Please note that each ticket holder is allowed one pass through the buffet line. This is NOT an all you can eat buffet.

 

Number of additional dinners: Choose Option 1 2 3 4 5 6

 

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Entry fee enclosed:

 

Entry fee for vessel plus 4 anglers:

 

Additional anglers:

 

Additional tee shirts:

 

Additional awards banquet dinners:

 

TOTAL ENTRY FEE:

 

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Signatures:

 

By signing this official entry form as an adult, I agree to abide by the tournament rules, accept responsibility for reading and understanding the official rules of the tournament, and consent to the use of any photographs or video throughout the event. Parent or guardian must sign for anglers under the age of 16.

 

Signature angler 1

 

Signature angler 2

 

Signature angler 3

 

Signature angler 4

 

Please print out completed form and mail, with payment, to: STCMC 2010 Fishing Tournament, 1200 South Federal Highway, Pompano Beach, Florida 33062