NOMINATION FORM CAIRNS BLUEWATER BILLFISH TOURNAMENT 2015 19,20,21,22, AUGUST VESSEL NAME:………………………..LENGTH: …………….VESSEL MAKE:………………………… RADIO FREQ:…………………………….ENGINE MAKE:………………………………………………… SKIPPERS NAME:…………………………………….Email:……………………………………………….. Mobile No: …………………………………………….. Boat Insurance details:Mandatory to be photocopied and attached. Company______________________Policy No_____________________Expiry Date_________________ It is the responsibility of the boat owner/skipper to ensure the boat carries all safety gear as is required by law and that their vessel is in a safe and seaworthy condition.It is the boat owner/skipper’s responsibility to carry Public Liability Insurance to the required amount.The Cairns Bluewater Game Fishing Club takes all care,but no responsibility is taken in the event of an accident or misadventure. ANGLER NAME 1. ANGLER NAME 2. M/F/J Club M/F/J Club Shirt Size: Ladies 14.16.18. Mens. M-L-XL-2XL-3XL ANGLER NAME 3. Shirt Size: Ladies 14,16,18 Mens. M-L-XL-2XL-3XL ANGLER NAME 4. M/F/J M/F/J Club Shirt Size: Ladies 14.16.18.Mens. M-L-XL-2XL-3XL Club Shirt Size: Ladies 14.16.18.Mens. M-L-XL-2XL-3XL Competing anglers must be a member of a club affiliated with QGFA or GFAA and may be required to provide proof of membership.New membership to the CBGFC is available at registration $80.00 Please make cheques payable to: Entry Fees and Additional Costs (GST inc) Entry Per Angler $395.00 x ____$_______________ Non-competing Crew Package (Meals only) $295.00 x____ $_______________ Late Fee applies after 1st July $ 50.00 x____$________________ The Treasurer CBGFC Extra Presentation Dinner $ 65.00 x____ $________________ P.O.Box 4741,Cairns Qld 4870 Fax:+61 7 4051 5161 Extra Tournament Shirt $ 60.00 x____ $_______________ TOTAL: AUD $_______________ Direct Deposit: Bank of Qld (Ref: Boat Name) BSB:124 001 Acct No: 90522843 Disclaimer: We that have entered the tournament, agree to the rules as published. I/We absolve the Cairns Bluewater Game Fishing Club Inc., it’s committee,officers,members and sponsors as such from any liability whatsoever arising and occurring or resulting from the tournament, and I/We hereby indemnify you and agree to keep you indemnified against all claims, damages, costs and loss that may be claimed or awarded or to any property of my/our invitees, licensees or guests against you, or that you may suffer resulting from injury or loss to me/us or any of my/our invited invitees or licensees or guests. Signed (Team Captain___________________________________________Date_____________________________________