Ditchman • NUCA of Florida Ditchmen - Sep 2019 | Page 53

2019 NUCA of SWFL Annual Fishing Tournament Registration Form OCTOBER 4TH & 5TH ‘TWEEN WATERS INN CAPTIVA ISLAND, FL ALL ANGLERS, JR. ANGLERS, GUESTS, & CHILDREN MUST BE REGISTERED IN ADVANCE Angler Registration / Shirt Size List Names (List Calcutta Information on Separate Registration Form Jr. Angler Registration / Shirt Size Must Be 14 Years Old or Younger (Jr. Anglers Are Eligible For the Calcutta) ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ _______________________________________ Guest Registration / Shirt Size Child Registration / Age / Shirt Size Charge $200.00 EachTotal Anglers: ______ List Names (Other Than Anglers) ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ Charge $120.00 EachTotal Guests: _______ Total Total Total Total Total Charge $50.00 Each List Names Total Jr. Anglers: ______ (Other Than Jr. Anglers) ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ Charge $25.00 Each Total Children: ______ Anglers X $200 each = $__________ Jr. Anglers X $50 each =$__________ Guests X $120 each = $__________ Children X $25 each = $__________ Calcutta X $50 each = $__________ (Total from Calcutta Form) Grand Total = $_________ Check # ________ Company: _______________________________________________________________ Contact: __________________________ Phone #:____________________ Single night registration for Friday, Oct. 4 th or Saturday, Oct. 5 th is available upon request for $75.00 per night. Registration form must be received in advance to guarantee reservations by September 20, 2019. Please send completed form to Rhonda Cason at NUCASWFL@g mail.com 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 Mye rs, FL 33906. If any additional information is needed please contact Chris Stewart at 239-633-2553 or Rhonda Cason at 239-939-1952. Thank you and we look forward to seeing you there! PARTICIPANTS IN THE NUCA OF SWFL ANNUAL FISHING TOURNAMENT ENTER AT THEIR OWN RISK. OFFICIALS, 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 EQUIP- MENT, WHICH MAY OCCUR DURING THIS TOURNAMENT. NAME OF APPLICANT _____________________________________ SIGNATURE _________________________________________