Kingfish Cup ID #  ______________________

 

Captain’s Name:  __________________________________________________

 

Captain’s Birth Date:  _______________________________________________

 

Boat Name:  ______________________________________________________

 

Contact Phone:  ____________________________________________________

 

Contact Email:  ____________________________________________________

 KFC T-Shirt Sizes (Complimentary)

Capt. Shirt Size: ___________________________________________________

Co-Capt. Shirt Size: _________________________________________________

LEVELS TO ADD:

Level I-  $1500                     _____________

Level II- $2500                    _____________

Level III- $3500                   _____________

 

TOTAL ENCLOSED             _____________

 

Make checks payable to:
Kingfish Cup, LLC
1770 Twiste Oak Ln SW  - Ocean Isle Beach, NC  -  28469

*  You may also drop this entry at the Ocean Isle Fishing Center with the retail store clerk