Enter : 5th Annual Charity Fishing Contest

Enter Online

Please fill this form out to enter the 5th Annual Charity Fishing Contest.

What contest do you want to enter ?

Water Contest

Land Contest

Are you entering as a

Adult $50

Junior $25 14 Years and Under

Family $125 2 Adults and 2 Juniors

Basic Details

Name

Address

Date of Birth

Phone

Mobile

Email

Basic Details - Contestant 2

Name

Address

Date of Birth

Phone

Mobile

Email

Basic Details - Junior Contestant 1

Name

Address

Date of Birth

Please enter a date on or after 07/02/2006

Phone

Mobile

Email

Basic Details - Junior Contestant 2

Name

Address

Date of Birth

Please enter a date on or after 07/02/2006

Phone

Mobile

Email

Boat Information

Boat Name

Are you the skipper ?

Yes No

Skippers Name

VHF Call Sign

Trailer Registration

You will be redirected to the Petone Working Men's Club payment page.

By completing this form, you acknowledge the risks associated with fishing and related activities and enter this contest at your own risk.