NUCA of CENTRAL FLORIDA
2021 INSHORE CLASSIC REGISTRATION & SPONSORSHIP FORM
Please provide a boat name and designated captain for each team registered
Company Name : ______________________________ Your Name : ____________________________ Phone : ____________________________
Boat / Team Name : ______________________
Email : ____________________________
Captain : __________________________
# 1 _______________________ / Shirt Size _________ Fishing ($ 150 )_____ Meal Only ($ 30 )____ # 2 _______________________ / Shirt Size _________ Fishing ($ 150 )_____ Meal Only ($ 30 )____ # 3 _______________________ / Shirt Size _________ Fishing ($ 150 )_____ Meal Only ($ 30 )____
Boat / Team Name : ______________________
Captain : __________________________
# 1 _______________________ / Shirt Size _________ Fishing ($ 150 )_____ Meal Only ($ 30 )____ # 2 _______________________ / Shirt Size _________ Fishing ($ 150 )_____ Meal Only ($ 30 )____ # 3 _______________________ / Shirt Size _________ Fishing ($ 150 )_____ Meal Only ($ 30 )____
Registrations _____ x $ 150 $__________
Meal Only _____ x $ 30 $__________
Sponsorship __________ $__________
TOTAL AMOUNT DUE :
$_________________ Credit Card Number : _________________________________
Exp .: ______________ Billing Zip Code : ______________ CVV Code : ______________
_________________________________ Name Printed on Card
______________________________ Signature
ARE YOU WILLING TO DONATE A DOOR PRIZE ? YES _____
NO _____
List Item ( s ): ________________________________________ ( thank you !)
Payments may also be made by check and mailed to : P . O . Box 10097 , Cocoa , FL 32927 .
Contact : Karen DeWitt ( 321 ) 795-0894 , ( 888 ) 822-8908 / fax , nucacentralflorida @ bellsouth . net
36 DITCHMEN • SEPTEMBER 2021