34th Annual Fishing Tournament AGC FEC Fishing Tournament Brochure 1 | Page 4

To guarantee your reservation, payment must accompany this completed form. Surf & Turf Sponsor Goggle Eye Sponsor Wahoo Sponsor Blue Runner Sponsor Flying Fish Sponsor Bally Hoo Sponsor Dolphin Sponsor Kingfish Sponsor Banner Sponsor REGISTRATION DEADLINE: March 22, 2019 Company Name:_____________________________________ Contact Name:___________________________________ Phone:_____________________________________ E-Mail:__________________________________________________ BOAT ENTRY + 2 ANGLERS ($675 each) Boat Name: _______________________________________ If the Captain is fishing or attending the dinner, please put their name in an Angler or Dinner Guest space below and account for them in the total. Captain’s Name: ______________________________ Angler Name Boat Type: _______________________________________ Shirt Size: :______________________________________ Angler Name ADDITIONAL ANGLERS ($250 each) Angler Shirt Size: Name:_______________________________________ Angler Shirt Size: :_______________________________________ Shirt Size: Name:________________________________________ Shirt Shirt Size: Size: Angler Name:_______________________________________ Angler Name:________________________________________ Shirt Shirt Size: Size: Angler Name:_______________________________________ Angler Name:________________________________________ JUNIOR ANGLER (Age 14 and under $150 each) Shirt Shirt Size: Size: Jr. Angler Name:_________________________________________ Jr. Angler Name:_________________________________ BANQUET GUEST ($200 each) Guest Name:_________________________________________ Guest Name:_____________________________________ Guest Name:_________________________________________ Guest Name:_____________________________________ Guest Name:_________________________________________ Guest Name:_____________________________________ Guest Name:_________________________________________ Guest Name:_____________________________________ ADDITIONAL SHIRTS…..$32.10 each (Sales Tax Included) Quantity of Shirts in Size Section below: PAYMENT: (Due with registration) CREDIT CARD GRAND TOTAL $__________ XS_____ S_____ M_____ L_____ XL____ 2XL_____ 3XL_____ REGISTRATION INFORMATION: Credit Payments add 2% to total. □ VISA □ MasterCard □ Amex □ Check Boat Entry $675 x ________ = $ ___________ Cardholder’s Name:____________________________________ Add. Anglers $250 x ________ = $ ___________ Card No. :_____________________________________________ Jr. Angler $150 x ________ = $ ___________ Exp. Date: ____________ Billing Zip Code:________________ Guests $200 x ________ = $ ___________ Sponsorship _______________ = $ ___________ Add. Shirts $32.10 x _______ = $ ___________ Total Amount Enclosed = $____________ Authorized Signature: _____________________________________________________ Make Checks Payable to: AGC FEC 2617 N Australian Avenue, West Palm Beach, FL 33407 Return form to [email protected] **No refunds for weather days or cancellations after Friday, March 22, 2019