Cape Lookout Shootout Registration Form

2014 CAPE LOOKOUT SHOOTOUT KMT SERIES

REGISTRATION FORM

BOAT NAME: _________________________________

BOAT REGISTRATION# OR COAST GUARD#: _____________

CAPTAINS NAME: _________________________

PHONE NUMBER: _________________________

EMAIL ADDRESS: __________________________

 

SIGNATURE REQUIRED: ______________________

PRINTED NAME: ___________________________

SOCIAL SECURITY NUMBER: __________________

 

CO-CAPTAIN: ______________________

*DEADLINE FOR DESIGNATING CO-CAPTAIN

IS JUNE 2, 2014

IF USING PAYPAL FOR YOU PAYMENT CHOICE PLEASE WRITE CONFIRMATION NUMBER BELOW

___________

**INSTRUCTIONS FOR PAYING BY PAYPAL:

LOGIN TO YOUR PAYPAL ACCOUNT AND CHOOSE SEND MONEY

ENTER OUR EMAIL CAPESHOOTOUT@GMAIL.COM

ENTER AMOUNT $1,875.00

CHECK BOX: I’M SENDING MONEY TO FAMILY AND FRIENDS

THIS WILL SHOW YOU ANY FEES ASSOCIATED WITH PAYING WITH YOUR CREDIT CARD, IF PAYING WITH YOUR CHECKING ACCOUNT THERE ARE NO FEES TO TRANSFER MONEY. IF YOU NEED FURTHER ASSISTANCE PLEASE CALL LISA WINSTEAD AT 252-883-5861. THANKS

 

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