Registration Form
MOORE FLATS FISHING
Fishing in Faith Kayak & SUP
Benefit Fishing Tournament
Registration Form
Competitor Name: ______________________________________
Competitor Address: ____________________________________
City: __________________ State: _______ Zip Code: _________
Cell Phone # (Required): _________________________________
Email (Required): _______________________________________
Date of Birth: ____________________ Age: _________________
Kayak/SUP Make: _______________ Model: ________________
Emergency contact name: ________________________________
Emergency contact number: ______________________________
Read Rules, Terms, and Conditions: Yes____ No_____
Completed and submitted Waiver of Liability: Yes____ No____
Signature: ______________________________________
Date: ______________________
---------------------------Do not write below this line---------------------------
Registration completed: Yes____ No____
Entry fee paid: Yes____ No____ Initials: ________ Date: __________
Waiver of Liability form signed and submitted: Yes____ No____
Competitor token #: __________________