ENTRY APPLICATION

40th Annual Greater Jacksonville Kingfish Tournament

GENERAL TOURNAMENT Lady Angler ___________

Thursday & Friday, July 16 & 17, 2020

Complete Rules Available at www.kingfishtournament.com.

Captain’s Name: (Last) (First) (Middle Name)

Sponsor Name:

Home Phone #: ( ) Mobile Phone #: ( ) Work Phone #: ( )

Emergency Contact: Contact #:

Address: City _______ State: Zip:

E-mail: _________ __________________ Jr. Angler Participant(s): Yes No SKA Member: _____Yes

BOAT IDENTIFICATION & SAFETY

Boat Name: State Reg.#:

Boat Manufacturer Engine Manufacturer:

Manufacturer Specified: Length (LOA): Model/Class: Color/Hull:

SINGLE ENGINE CLASS DOES THE REGISTERED BOAT QUALIFY FOR PARTICIPATION IN THE SINGLE ENGINE CLASS? CHECK ONE: Yes No

______________________________________________________________________________________________________________________________________________

Payment of the entry fee constitutes a representation by each Captain/Jr. Angler that he/she has read and understands the Tournament Rules and that he/she will abide

by such rules and the decisions of Tournament personnel. None of the amounts paid for entry should be considered as a charitable contribution.

Fees paid are not refundable, see rules for detail.

GENERAL TOURNAMENT ENTRY FEE: $295 ENTRY FEE: $_______ EARLY ENTRY FEE

FINAL ENTRY FEE

$295 Thru July 05$350 Thru July 15

MEGA LARGE TWT $250: $_____ _

$50: $ ____________ LARGEST TWT

2-DAY AGG TWT $ $50: _ _ JUNIOR ANGLER ENTRY FEE:

LADY ANGER ENTRY FEE:

$10.00 (per angler)

$25.00 (per angler) S. ENG HI-ROLLER LARGE TWT $200 $ _

$50 : $ ___________

$500: $ _

SINGLE ENG LARGE TWT

SUPER TWT

JR ANGLER ENTRY FEE(S): Make checks payable to:

Mail to: LADY ANGLER

$ 10 $ _

$ 25 $____________

TOTAL: $ _________

Questions:

GREATER JACKSONVILLE KINGFISH TOURNAMENT

8203 Heckscher Drive, Jacksonville, FL 32226 Contact

904-251-3011 or gjkt@kingfishtournament.com

PAYMENT VIA CREDIT CARD: Fax to (904) 251-3738 OR register online at www.kingfishtournament.com

Type: VISA MasterCard American Express

Card # CVC # Exp. Date: TOTAL: $ ___

RELEASE: Read carefully before signing. In consideration for the acceptance of my entry, I, for myself, personal representatives, heirs and executors, release and forever discharge Jacksonville Marine

Charities, Inc., d/b/a the Greater Jacksonville Kingfish Tournament, the City of Jacksonville, Florida, all sponsors, contributors, participants, volunteers,

producers, their agents, representatives, successors and assigns of all liabilities, claims, actions, damages, costs or expenses for bodily injury, death or property

damages, which I may have against them arising out of or in any way connected with my participation in this Tournament, including but not limited to, all risks,

known or unknown, anticipated or unanticipated, without regard to whether they are inherent in participating in a fishing tournament. I understand that this

release is an unconditional, full and general release, which includes all claims whether caused by the gross or simple negligence, action or inaction of any of the

released parties. I hereby authorize the use of my name and/or likeness as well as that of my vessel and all crew members, free of further consideration, for

promotion and advertising purposes in any media form and reproduction, including but not limited to radio, television, newspaper, brochure, online or video.

Signature of Captain: _________________________________________________________

FOR OFFICE USE ONLY

Boat No.

Jr. Angler

Date Pd

CK ____ CC _____ Cash____

Amount Pd

Entered to QB __________

Registration Count

Electronic Equipment: VHF Radio-25 Watt (Mandatory)

Depth Recorder Radar GPS EPIRB

YES NO

Due to the COVID-19 Pandemic “The Greater Jacksonville Kingfish Tournament” will follow all Social Distancing Mandated by the Federal, State and Local Governments.