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2019 REGISTRATION FORM TEAM INFORMATION ENTRY FEES - BIG BOAT DIVISION Team Name: Captain Name: Boat Name: Boat Size (LOA): Captain Phone: Credit Card Local Bank Deposit Local Bank Transfer (SINPE) BANK INFORMATION: IFISH QUEPOS, S.A. / Cédula Jurídica: 3-101-614831 Bank: Banco Promerica / Account ID in USD: 4000764296 Cuenta Cliente(SINPE): 11600104007642964 International Wire Transfer PAYMENT METHODS MARCH 14 TH -16 TH , 2019 8 T H ANN U A L Angler #5 Lady Angler Junior Angler (place "x" if applicable) Name: Email: Phone: Angler #4 Lady Angler Junior Angler (place "x" if applicable) Name: Email: Phone: Angler #6 Lady Angler Junior Angler (place "x" if applicable) Name: Email: Phone: Angler #2 Lady Angler Junior Angler (place "x" if applicable) Name: Email: Phone: Team Contact: Angler #1 Lady Angler (place "x" if applicable) Name: Email: Phone: Angler #3 Lady Angler Junior Angler (place "x" if applicable) Name: Email: Phone: Tournament updates, instructions, confirmations or refunds are sent to the Team Contact. This information must be complete. All tournament communication will first be sent by email and subsequent contact attempts will be made by phone call. Note: Angler #1 denotes Team Capitain. Shirt Size S M L XL XXL 3XL Shirt Size S M L XL XXL 3XL Shirt Size S M L XL XXL 3XL Shirt Size S M L XL XXL 3XL Shirt Size S M L XL XXL 3XL Shirt Size S M L XL XXL 3XL Team Entry Fee $3,000 Billfish Release Jackpot (optional) $1,000 per day Tuna Jackpot (optional) $300 per day Dorado Jackpot (optional) $300 per day All In $6,200 ENTRY FEES - SMALL BOAT DIVISION Team Entry Fee $1,000 Billfish Release Jackpot (optional) $300 per day Tuna Jackpot (optional) $300 per day Dorado Jackpot (optional) $300 per day All In $2,800 Credit Card Information Card Type: Card Number: Exp. Date: Name on Card: Address: City, state, zip: Phone No: Signature: MARINA PEZ VELA TOURNAMENTS Tel: (506) 2774-9006 • Toll Free: 1-866-739-8352 [email protected] www.marinapezvelatournaments.com Credit Cards will be processed upon submission. Please scan and email your registration form to [email protected]
