PLEASE PRINT CLEARLY AND LEGIBLY.Name: Age: Birthdate:
CaptainName:CaptainPhone:
EmailAddress:
If fishing from a boat please enter required boat information.BoatName StateRegistration#
BoatManufacturer Engine(s)Manufacturer
Length HullColor Trim
Waiver:Pleasereadcarefullybeforesigning.Astheparentand/orCaptainofthevesseloftheabovenamedparticipant(s),thisistoacknowledgethatIrealizethatmychildisparticipatingintheJuniorKingfishChallengeathisorherownrisk.IconfirmthatwehavereadandfullyunderstandtherulesoftheTournamentandthiswaiverandagreetoabidebytherulesandtermsofthiswaiver.Iagreethatinconsiderationfortheacceptanceofthisentryandofmychild’sparticipationintheJuniorKingfishChallengeTournament,formychildandmyself,IherebyreleaseandforeverdischargeAncientCityGameFishAssociation,Inc.(ACGFA)d/b/aKingfishChallengeTournament,theirsponsors,representatives,successorsandassignsofallliabilities,claims,actions,damages,costsorexpenseswhichIormychildmayhaveagainstthemarisingoutoforinanywayconnectedwithmychild’sparticipationinthisevent.Iunderstandthatthiswaiverincludesanyclaimsbasedinnegligence,actionorinactionofanyoftheabove-namedparties.Iherebyauthorizetheuseofmychild’snameandorlikenessaswellasthatofallcrewmembers,freeofanyconsideration,forpromotionandadvertisingpurposesinanymediaformandreproduction,including,butnotlimitedtoradio,television,newspaper,brochure,videoorinternet.
Enter Early! Tournament limited to 125 Junior Anglers
Entry to the Junior Challenge allows the senior angler, junior angler or small-fry angler to fish in BOTH the Kingfish division or Redfish division. The top 3 entrants in each age division and fish division will be awarded prizes (18 prizes in total). Prizes are limited to 1 per angler and will automatically be sorted to the prize of greatest value.
Only $25 Registration
JUNIORCHALLENGE
ANCIENTCITYGAMEFISHASSOCIATION
Twowaystoregister!Mailcompletedformandpaymentto:
Kingfish ChallengeP.O. Box 2001
St. Augustine, FL 32085Registeronlineatwww.acgfa.com/
challenge-tournamentsTournamentHotline904-669-5153
EntryFeesincludeSTATEofFLORIDASALESTAX.
Disclaimer: Please read carefully before signing. The tournamentcommittee,atitsdiscretion,mayasktheentrantstosubmittoapoly-graphexaminationiftheentrantswishtobeconsideredforprizesinthetournament.Bysigningtheentryform,eachentrantagreesthatthetournamentcommitteeistobethefullandfinalarbitratorofrulesanddisputeswhichmayarise.Further,entrantacknowledgetheentryformisabindingcontractbetweenthetournamentandtheentrant,andthatthedecisionofthetournamentcommitteeisfinalandisnotreviewablebyacourtoflaw.
$ TotalEntryFee($25/angler)CASHORMONEYORDERATREGISTRATION,
CREDITCARDSACCEPTED-$5PROCESSINGFEE.
AnglerParentorLegalGuardianSignature
CREDITCARD/SQUARE CASH
CHECK DONATION______________
[]SmallFry[]Junior[]Senior
[]Checktheboxatleftifyoudonotwanttoreceiveoffersfromourvaluedsponsorsandpartnersviaemail.
Bysigningthisform,entrantgrantspermissiontousehisorherimageandallteammembersinvideoorphotographsforsocial
media,media,promotional,andmarketingpurposes.
