One Base Registration Form
Fill out the form carefully for registration
Boat
*
Skippers Name
*
If Skipper is fishing, please enter as an angler below as well
Email
*
example@example.com
Skippers Phone Number
*
-
Mobile Prefix
Phone Number
Bonanza (optional) - $150.00 per boat
*
Please Select
Yes
No
Heaviest Marlin for the tournament - the team with the heaviest marlin landed over 120kg for the tournament will take out the prize pool
Angler 1
*
First Name
Last Name
Type of Entry
*
Senior Angler
Junior Angler (under 17 years)
Club Name & Membership Number
*
Current Membership
*
Please Select
Yes
No (select New Membership type below)
New Membership (Only fill out if you answered NO above)
Please Select
Annual Senior (aged 22 or over)
Annual Intermediate (aged 17 - 21)
Annual Junior (aged 16 or under)
7 Day Membership
1 Day Membership
Jackpot (optional) - $5 for both guesses
*
Please Select
Yes (enter guess below)
No
Guess the weight of the heaviest Marlin & Tuna
Marlin Guess
Tuna Guess
Angler 2
First Name
Last Name
Type of Entry
Senior Angler
Junior Angler (under 17 years)
Club Name & Membership Number
Current Membership
Please Select
Yes
No (select New Membership type below)
New Membership (Only fill out if you answered NO above)
Please Select
Annual Senior (aged 22 or over)
Annual Intermediate (aged 17 - 21)
Annual Junior (aged 16 or under)
7 Day Membership
1 Day Membership
Jackpot (optional) - $5 for both guesses
Please Select
Yes (enter guess below)
No
Guess the weight of the heaviest Marlin & Tuna
Marlin Guess
Tuna Guess
Angler 3
First Name
Last Name
Type of Entry
Senior Angler
Junior Angler (under 17 years)
Club Name & Membership Number
Current Membership
Please Select
Yes
No (select New Membership type below)
New Membership (Only fill out if you answered NO above)
Please Select
Annual Senior (aged 22 or over)
Annual Intermediate (aged 17 - 21)
Annual Junior (aged 16 or under)
7 Day Membership
1 Day Membership
Jackpot (optional) - $5 for both guesses
Please Select
Yes (enter guess below)
No
Guess the weight of the heaviest Marlin & Tuna
Marlin Guess
Tuna Guess
Angler 4
First Name
Last Name
Type of Entry
Senior Angler
Junior Angler (under 17 years)
Club Name & Membership Number
Current Membership
Please Select
Yes
No (select New Membership type below)
New Membership (Only fill out if you answered NO above)
Please Select
Annual Senior (aged 22 or over)
Annual Intermediate (aged 17 - 21)
Annual Junior (aged 16 or under)
7 Day Membership
1 Day Membership
Jackpot (optional) - $5 for both guesses
Please Select
Yes (enter guess below)
No
Guess the weight of the heaviest Marlin & Tuna
Marlin Guess
Tuna Guess
Angler 5
First Name
Last Name
Type of Entry
Senior Angler
Junior Angler (under 17 years)
Club Name & Membership Number
Current Membership
Please Select
Yes
No (select New Membership type below)
New Membership (Only fill out if you answered NO above)
Please Select
Annual Senior (aged 22 or over)
Annual Intermediate (aged 17 - 21)
Annual Junior (aged 16 or under)
7 Day Membership
1 Day Membership
Jackpot (optional) - $5 for both guesses
Please Select
Yes (enter guess below)
No
Guess the weight of the heaviest Marlin & Tuna
Marlin Guess
Tuna Guess
Angler 6
First Name
Last Name
Type of Entry
Senior Angler
Junior Angler (under 17 years)
Club Name & Membership Number
Current Membership
Please Select
Yes
No (select New Membership type below)
New Membership (Only fill out if you answered NO above)
Please Select
Annual Senior (aged 22 or over)
Annual Intermediate (aged 17 - 21)
Annual Junior (aged 16 or under)
7 Day Membership
1 Day Membership
Jackpot (optional) - $5 for both guesses
Please Select
Yes (enter guess below)
No
Guess the weight of the heaviest Marlin & Tuna
Marlin Guess
Tuna Guess
Total to pay
*
Calculator
How would you like to Pay
*
At Club
Internet Banking (03-0497-0186604-00 Ref: Name / Code: Contest Name)
Credit Card (call 09-4343818 and pay over phone)
Additional Comments
Signature
*
Clear
Submit Application
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