PRINT THIS PAGE AND FILL OUT
2010  NC Kingfish Championship
ENTRY FORM

BOAT NAME:    _________________________________________BOAT LENGTH: _________

CAPTAIN'S NAME:    _____________________________________

ADDRESS:    ________________________________________________________________

CITY:    _____________________________    STATE:    ___________    ZIP:    ___________

PHONE:    __________________________   

 S.S.#    ______________________________ (required)

EMAIL ADDRESS:    _________________________________ (required)

DECLARE YOUR FISHING DAY

I CHOOSE TO COMPETE (Check Two Days or Choose to Call Hotline Later)        

• Sat November 13
• Sun November 14
• Mon November 15
• Tues November 16
• Wed November 17
• Thur November 18
• Fri November 19
• Sat November 20
• Sun November 21
• I will choose my days later by calling the hotline 910-253-3474   

_________________________ SIGNATURE  ________________ DATE

WAIVER CONTRACT:
I understand that I as registrant/captain/boat owner, am responsible for my boat
and occupants at all times.  I have read and fully understand and agree to abide
by all rules of the 2010 Fall Brawl King Classic.  I hereby release the Fall Brawl
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:    $200 BY 11/12/10    __________                                
ENTRY:    $250 after until 11/19/10   __________                                                        
Big Fish TWT:    $100   _______________
Aggregate (2 Fish) TWT:    $100    __________         
"High Rollers" TWT:    $200  _____________

FILL OUT THE ENTRY FORM, PRINT IT, INCLUDE PAYMENT AND MAIL TO TOURNAMENT HEADQUARTERS
Make checks payable to:
OIFC  -  65 Causeway Drive   -  Ocean Isle Beach, NC 28469