Jolly Mon 2017 Entry Form

2017 JOLLY MON KING CLASSIC
ENTRY FORM

BOAT NAME:    _____________________________   

 

CAPTAIN'S NAME:    ______________________________________________________________________

ADDRESS:    ______________________________________________________________________________

CITY:    ___________________________________________    STATE:    ___________    ZIP:    ___________

CELL PHONE:    __________________________   EMAIL ADDRESS:    _________________________________

S.S.#    ______________________________  (required)

JR. ANGLER NAME(S)& AGE(S):     _____________________________________________________________

                                                  _____________________________________________________________

LADY ANGLER NAME(S):  _____________________________________________________________________

                                    _____________________________________________________________________

SENIOR ANLGER NAME(S):  ___________________________________________________________________

BOAT LENGTH (Tip of bow rub rail to stern rub rail):___________        BOAT BRAND:  _______________________

# OF ENGINE(s):  _________  TOTAL HP OF ALL ENGINE(s):  _____________   ENGINE BRAND:  _______________

KINGFISH CUP PARTICIPANT?  YES or NO?  If YES, KFC registered Capt's name:  _____________________________

DECLARE YOUR FISHING DAY

I CHOOSE TO COMPETE:

_____  SAT, June 17 

_____  SUN, June 18

WAIVER CONTRACT:
I understand that I as registrant/captain/boat owner, am responsible for my boat and occupants at all times.  I further acknowledge that the boat in which I am participating has or will have liability insurance coverage in place at the time of this event.  I have read and fully understand and agree to abide by all rules of the 2017 Jolly Mon King Classic.  I hereby release the Jolly Mon King Classic, its sponsors, their principles, theirs subsidiaries, and their affiliates from any and all liability.  I further understand that the decision to fish and participate is the responsibility of the registrant/captain/boat owner.

SIGNATURE:    _________________________________________________    DATE:    ______________

EARLY ENTRY:    $215 BY 6/12/17   _______     ENTRY: $250 after _______                                                      

BREAK THE RECORD TWT:  $20  __________

BIG FISH TWT:  $100  __________

WHALE TWT:  $500  __________

HIGH ROLLERS TWT:  $250  __________

SMALL BOAT TWT:  $100  __________

LADY ANGLER:  $100  __________

                                                                 

FILL OUT THE ENTRY(Entry deadline 6/16/16), PRINT IT, INCLUDE PAYMENT AND MAIL
Make checks payable to:
Jolly Mon King Classic- JMKC -  P.O. Box 895 - Shallotte, NC  28459

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