Alice Kelly Memorial Entry Form | Tournament Control

BOAT & CREW INFORMATION

Boat Name*

Team Name (if different than boat name)

Boat Make*

Length*

Captain*

First Mate

Second Mate

TEAM CONTACT

Contact Name*

Mailing Address*

City | State | Zip*

Mobile Phone*

Email*

Check if Team Contact is also an Angler

Angler

ENTRY LEVELS & FEES

Entry Fee proceeds and 15% of the Dolphin Jackpot are donated to Interfaith Community Outreach and are tax deductible.

Entry Levels

E1-Team Entry ($600)
E2-Dolphin Jackpot ($500)

Team Entry

Price: $600.00

Dolphin Jackpot

Price: $500.00

Donation

Spearfish ($25)
Sailfish ($50)
White Marlin ($75)
Blue Marlin ($100)
Grand Slam ($250)

$25 Donation

Price: $25.00

$50 Donation

Price: $50.00

$75 Donation

Price: $75.00

$100 Donation

Price: $100.00

$250 Donation

Price: $250.00

Total Due

$0.00

PAYMENT OPTIONS

We accept checks and American Express, Visa and MasterCard—PCBT imposes a 3.75% surcharge on credit cards, which is not greater than our cost of acceptance.

Choose One of the Following Options*

I am mailing a check.
I will pay at Registration.
I will pay now with a credit card.

Make checks payable to PCBT
Mailing Address
Alice Kelly Memorial Tournament
PO Box 187
Manteo, NC 27954

Subtotal

$0.00

Credit Card Surcharge (3.75%)

$0.00

Total

$0.00

Name on Credit Card*

Credit Card Number*

Expiration Date*

CVV (Security Code)*

Billing Zipcode*

Signature*

I agree to pay according to my card holder agreement.

Phone

This field is for validation purposes and should be left unchanged.

Alice Kelly Memorial Ladies Only Billfish Tournament

2019 ENTRY FORM

BOAT & CREW INFORMATION

TEAM CONTACT

ENTRY LEVELS & FEES

PAYMENT OPTIONS