One Base Registration Form
Fill out the form carefully for registration
Boat
*
Skippers Name
*
Email
*
example@example.com
Skippers Phone Number
*
-
Mobile Prefix
Phone Number
Optional; Bonanza - $150 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
Club
*
Membership Renewal
*
Please Select
Yes
No
New Membership
*
Please Select
Yes
No
7 Day Membership
*
Please Select
Yes
No
Optional; Jackpot - $5
Guess the heaviest Marlin & Tuna
Marlin Guess
Tuna Guess
Angler 2
First Name
Last Name
Type of Entry
Senior Angler
Junior Angler
Club
Membership Renewal
Please Select
Yes
No
New Membership
Please Select
Yes
No
7 Day Membership
Please Select
Yes
No
Optional; Jackpot - $5
Guess the heaviest Marlin & Tuna
Marlin Guess
Tuna Guess
Angler 3
First Name
Last Name
Type of Entry
Senior Angler
Junior Angler
Club
Membership Renewal
Please Select
Yes
No
New Membership
Please Select
Yes
No
7 Day Membership
Please Select
Yes
No
Optional; Jackpot - $5
Guess the heaviest Marlin & Tuna
Marlin Guess
Tuna Guess
Angler 4
First Name
Last Name
Type of Entry
Senior Angler
Junior Angler
Club
Membership Renewal
Please Select
Yes
No
New Membership
Please Select
Yes
No
7 Day Membership
Please Select
Yes
No
Optional; Jackpot - $5
Guess the heaviest Marlin & Tuna
Marlin Guess
Tuna Guess
How would you like to Pay
*
At Club
Internet Banking
Credit Card
Additional Comments
Signature
Clear
Submit Application
Clear Fields
Should be Empty:
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