Jolly Mon 2019 Entry Form

2019 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):  ___________________________________________________________________

TOTAL HP OF ALL ENGINE(s):  _____________     BOAT LENGTH (as advertised by mfg):___________        

BOAT BRAND:  _______________   ENGINE BRAND:  _______________      

KINGFISH CUP PARTICIPANT?  If YES, KFC number & Capt's name:  #____________ Name:_______________________

DECLARE YOUR FISHING DAY

I CHOOSE TO COMPETE:

______  SAT, June 15          _______  SUN, June 16         _______  I WILL CALL TO DECLARE

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 2019 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:    ______________

ENTRY: $300  _______                                                      

BREAK THE RECORD TWT:  $20  __________   (current accrued pot is $4300)

BIG FISH TWT:  $100  __________

WHALE TWT:  $500  __________

HIGH ROLLERS TWT:  $250  __________

SMALL BOAT TWT:  $100  __________

LADY ANGLER:  $100  __________

   FILL OUT THE ENTRY, 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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