August Ditchmen | Page 36

2015 NUCA of SWFL Annual Fishing Tournament SEPTEMBER 18 & 19 CAPTIVA ISLAND, FL TWEEN WATERS INN Tournament Registration Form ALL ANGLERS, JR. ANGLERS, GUESTS, & CHILDREN MUST BE REGISTERED IN ADVANCE Angler Registration List Names (List Calcutta Information on Seperate Registration Form) ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ Charge $180.00 Each Total Anglers: ______ Jr. Angler Registration Must Be 14 Years Old or Younger (Jr. Anglers Are Eligible For the Calcutta) ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ Prizes for: Jr. Angler Most Fish, Jr. Angler Heaviest Fish Charge $30.00 Each Total Jr. Anglers: ______ Guest Registration List Names (Other Than Anglers) ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ Charge $105.00 Each Total Guests: ______ Child Registration Children 16 and Under Are Free, However, Each Child Must Be Listed With Their Age Below and Must Be Registered in Advance. ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ Total Children: ______ Total Anglers X $180 each = $__________ Total Jr. Anglers X $30 each = $__________ Total Guests X $105 each = $__________ Total Calcutta X $50 each = $__________ (Total From Caclcutta Form) Grand Total = $___________ Check # ______ Company: Contact: Phone #: Fax #: __________________ __________________ __________________ __________________ Registration form must be received in advance to guarantee reservations by September 15, 2014. Please send completed form to Rhonda Cason at [email protected] or 239-790-1369 (fax). If paying by check, please make payable to NUCA of SWFL and send to Rhonda Cason; P.O. Box 62207 Fort Myers, FL 33906. If any additional information is needed please contact Bob Russell at 239-574-4174 or Rhonda Cason at 239-939-1952. Thank you and look forward to seeing you there! PARTICIPANTS IN THE NUCA OF SWFL ANNUAL FISHING TOURNAMENT ENTER AT THEIR OWN RISK. OFFICALS, COMMITTEE MEMBERS, ‘TWEEN WATERS INN PERSONNEL, AND ALL PERSONS CONNECTED DIRECTLY OR INDIRECTLY WITH NUCA OF SWFL, SHALL BE EXEMPT FROM ANY LIABILITY FOR LOSS, DAMAGE, NEGLIGENCE, HARM OR INJURY SUFFERED BY ANY PARTICIPANT, ENTRANT, SPORT FISHERMAN, THEIR COMPANIONS, BOAT CAPTAINS, AND CREW MEMBERS, VESSELS AND EQUIPMENT, WHICH MAY OCCUR DURING THIS TOURNAMENT. NAME OF APPLICANT ___________________________ SIGNATURE _______________________________