application

26th Annual Tuna-Ment * June 19 – 21, 2015
8461C Fort Smallwood Rd - Pasadena, MD 21122 • Email: [email protected] - Website: www.mssa.net - Telephone: 410-255-5535 - Fax: 410-255-1552
CAPTAINS’ MEETINGS:
ALL Meetings to be held JUNE 18th – 6PM to 8PM
*Ocean City, MD – Alltackle
*Wachapregue, VA – Seaside Marina
*Chincoteague, VA – Captain Steve’s Bait & Tackle
*Indian River Inlet - Hook’em & Cook’em
CAPTAIN (PLEASE PRINT CLEARLY)
Name:
Address:
City/State/Zip:
Home Phone:
Captain of the Year Bonus Points Eligibility?
Cell Phone:
Are you paying for a for-hire fishing vessel in this tournament?
eMail:
YES
NO
(CELL PHONE & EMAIL NEEDED FOR UPDATES DURING TOURNAMENT)
ALTERNATE CAPTAIN (Optional)
ENTRY FEE
Name:
Member Rates: $200 Before JUNE; $250 in JUNE
Non-Member Rates: $250 Before JUNE; $300 in JUNE
Address:
Home:
Cell:
TOURNAMENT WITHIN TOURNAMENT
Each TWT is a separate & OPTIONAL selection NOT included in the Main
Tournament Entry Fee. You may enter any combination of the TWTs.
Please see official tournament Rules & Regulations for more information.
eMail:
MEMBERSHIP
CHAPTER OPTIONS:
Annapolis Atlantic Coast Broadneck/Magothy Carroll County
DC Metro
Dorchester County
Essex-Middle River
Frederick County
Kent Island
Northern Bay
Northwest
Perry Hall
Southern MD
Susquehanna
*
Captain
Individual
Family
Chapter (select one):
Alt. Captain
Individual
Family
Chapter (select one):
$
ENTRY FEE TOTAL
City/State/Zip:
New
1 Year $25
1 Year $30
Renew
3 Year $65
3 Year $70
New
1 Year $25
1 Year $30
Renew
3 Year $65
3 Year $70
Membership TOTAL
____$50 Tuna(2 fish stringer) ____$300 Tuna(6 fish stringer)
____$100 Tuna(2 fish stringer) ____$500 Tuna(single fish)
____$200 Tuna(3 fish stringer) ($500 TWT is ONE WINNER)
$
TWT TOTAL
SPECIAL CATEGORY
$100 Dolphin (up to 3 Heaviest)
(1st & 2nd Places ONLY – split 70/30)
$
SPECIAL TWT TOTAL
MAIL CAPTAIN’S PACKET
OPTIONAL – if unable to attend any Captains’ Meeting
Must have Captain number to participate in tournament
$20 Mail Packet Fee
$
MAIL PACKET TOTAL
$
GRAND TOTAL
Check #
$
CAPTAIN SIGNATURE (REQUIRED)
X
I have read & will abide by the official Rules & Regulations of the tournament &
agree to them without exception. The accuracy of the data entered on this
application is understood to be the responsibility of the captain. It is the
responsibility of the registered captain (applicant) to verify the MSSA
membership status of self and the Alternate Captain (if listed on application) for
eligibility of All MSSA Crew Bonus and discounted entry.
Cash
Credit Card: Visa
Discover
American Express
Card #
Expiration:
Date Received:
M/C
MSSA Office Use ONLY
Amount Received:
/
By:
__
BOAT #_____________