PRINT THIS PAGE AND FILL OUT
2016  JUNIOR JOLLY MON
ENTRY FORM

BOAT NAME:    _________________________________________

CAPTAIN'S NAME:    _____________________________________

ADDRESS:    ________________________________________________________________

CITY:    _____________________________    STATE:    ___________    ZIP:    ___________

CELL PHONE:    __________________________   

EMAIL ADDRESS:    _________________________________

JUNIOR ANGLER #1 _____________________________AGE_________

JUNIOR ANGLER #2 _____________________________AGE_________

JUNIOR ANGLER #3 _____________________________AGE_________

JUNIOR ANGLER #4 _____________________________AGE_________

JUNIOR ANGLER #5 _____________________________AGE_________

JUNIOR ANGLER #6 _____________________________AGE_________

YOUR FISHING DAY:  Fishing will be from 7:00 AM – 3:00 PM on Friday, JUNE 17th

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 2016 Junior Jolly Mon Tournament.  I hereby release the Junior Jolly Mon Tournament, 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.

APPLICANT SIGNATURE:    ____________________________________    DATE:    _________________

ENTRY:    $25 PER Junior Angler (MUST BE RECEIVED BY 6/16/16)    __________                                

FILL OUT THE ENTRY FORM, PRINT IT, INCLUDE PAYMENT AND MAIL/DROP TO TOURNAMENT HEADQUARTERS
Make checks payable to:
Junior Jolly Mon- JJM
P.O. Box 895
Shallotte, NC  28459

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