Coomera Waters Mangrove Jack Open Entry Form
MANGROVE JACK COMPETITION
COMPETITION DATE: 1ST AUGUST 2026
Start 6:00 am End 6:00pm STRICTLY
Team Name (if Applicable)
The Fish Whisperers
Entry Type
*
Single Entry $65
Family Entry $100
Entrant Name
First Name
Last Name
Mobile Number
*
Email1
*
example@example.com
Boat size & Brand (in metres)
E.G Bar Crusher - Light Blue
Boat registration No (If applicable
Boat name (if applicable)
The Yellow Surbmarine
Boat Colour
Banana Yellow
Emergency contact name (Person not 0n the boat with you)
*
I just call her 'The Wife'
Emergency contact phone number
*
Mobile no. please
I confirm the skipper will provide a safety briefing before embarking on a boat
*
I confirm
I confirm my emergency contact will know my plan, including return time and area to be fished before embarking on a boat
*
I confirm
Payment
Entry Fee
*
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( X )
Entry Fee
Fee for form entry
Free
$
Free
Family Entry
Family Members
*
Rows
Name
Age Group
Mobile Number
Adult 1
Adult 2
Child 1
Child 2
Child 3
Child 4
Timestamp
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Submit
Should be Empty: