Fishing Competition Form

Fishing Competition Form
Event date
Competing boat details
Boat name*
Boat model*
Skipper name*
First NameLast Name
Cell phone*
Email*
example@example.co.nz
Region*
Skipper T-shirt size*
Support coastguard?
Donate $10 to Coastguard
Emergency contact details
Please provide contact details for someone not on the boat
Name*
First NameLast Name
Phone*
Boat crew
Add crew 1
1
Name
First NameLast Name
Email
Phone
T-Shirt
Region
Donate to coastguard ($10)
2
Add crew 2
3
Name
First NameLast Name
Email
Phone
T-Shirt
Region
Donate to coastguard ($10)
4
Add crew 3
5
Name
First NameLast Name
Email
Phone
T-Shirt
Region
Donate to coastguard ($10)
6
Add crew 4
7
Name
First NameLast Name
Email
Phone
T-Shirt
Region
Donate to coastguard ($10)
8
Add crew 5
9
Name
First NameLast Name
Email
Phone
T-Shirt
Region
Donate to coastguard ($10)
10
Add crew 6
11
Name
First NameLast Name
Email
Phone
T-Shirt
Region
Donate to coastguard ($10)
12
TotalToPay
Initial
Total to pay*
prevnext( X )
NZD13
Payment Methods
First Name Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and submit the form.
Should be Empty:

Competing boat details