FISHING TEAM REGISTRATION

FISHING REGISTRATION $65 per angler, after 4/11/19 cost is $75

Complete form below to create a new reservation.
$65 per angler, after 4/11/18 cost is $75

Student rate $50, after 4/11/18 $55 (college students must have current college ID to qualify)
Team Name
Captain Angler 1 *

First Name Last Name
If student - age
Phone *

- Area Code Phone Number
E-mail *
Shirt Size
Waiver/Release must be acknowledged by captain before mailing: In signing this release, my team, my teams heirs, executors and administrators forever release LCEC and all sponsors of the Fishing tournament and their respective directors, officers, employees and agents, of all claims of damage, injury demands, and actions whatsoever in a manner arising from my participation in this event. We grant permission for photos and other records of this event to be used to further the cause. *

AGREE
Angler 2

First Name Last Name
If student - age
Phone

- Area Code Phone Number
E-mail
Shirt Size
Angler 3

First Name Last Name
If student - age
Phone

- Area Code Phone Number
E-mail
Shirt Size
Angler 4

First Name Last Name
If student - age
Phone

- Area Code Phone Number
E-mail
Shirt Size
Angler 5

First Name Last Name
If student - age
Phone

- Area Code Phone Number
E-mail
Shirt Size
Payment

Check in mail. Please make check payable to LCEC/UW Please send an invoice to be submitted to my company. Employee payroll deduct I will be paying at the Captain's meeting
My Products

PAY FOR REGISTERED ANGLER $ 65.00

Quantity
Item subtotal: $ 0.00

PAY FOR REGISTERED STUDENT $ 50.00

Quantity

Total $ 0.00
LCEC Employee number
In the event of inclement weather, consider your entry fee a donation.

CHECKS PAYABLE TO: LCEC/UW

PAYMENT Send to: LCEC/Fish • P.O. Box 3455, N. Ft. Myers, FL 33918

239-656-2122
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FISHING REGISTRATION $65 per angler, after 4/11/19 cost is $75