b'OFFICIAL DERBY ENTRY FORMJAN. 8 - 11, 2020 Boat No.$1,000.00 per boat for WPBFC members$1,500.00 per boat for non members(by Dec. 20th)After Dec. 20th: $1,300 WPBFC members/ $1,800 non-members $175.00 per person for Derby dinner tickets (sold seperately) *for official use onlyENTRY FEE INCLUDES: Boat registration, official Derby boat kit filled with Silver Sailfish Derby burgee, two (2) cotton tournament tee shirts, Derby score sheets and fishing related goodies & gear!Dinner tickets must be purchased separately.*Tournament is limited to 50 vessels.Entries are taken on a first come, first served basis.At least one angler per boat has to be a WPBFC member in good standing to qualify for the member discount.Registrations must be received by Friday, December 20, 2019.A $300 late registration fee is applicable if full payment is not received as of this date.SORRY, NO RAIN CHECKS OR REFUNDS.Contact Name: Contact phone:Please Print ClearlyAddress:City:State: Zip:Email address:Boat Name:Boat Make: Length:Homeport:Captain: Capts. cell:List names of angler(s) fishing in the tournament(no limit to number of anglers) :1.2.Hometown:___________________________________Hometown:___________________________________3.4.Hometown:___________________________________ Hometown:___________________________________5.6.Hometown:___________________________________Hometown:___________________________________ Check(payable to the West Palm Beach Fishing Club) VISA Mastercard AmExExp. DateCCVWPBFC M eMBer($1,000) or N oN -M eMBer($1,500) e NtryF ee :$t Wo(2) L oNgS LeeveC ottoND erByt eeS -I NCLuDeD WIth eNtry :( PLeaSe CheCk SIzeS ) SM____ MeD____Lg____ xL____xxL____xxxL ____$ - 0 -L ater egIStratIoN Fee( aDDItIoNaL$300aFterD eC . 22 ND ):$D erByD INNert ICketS : @ $175eaCh :$a DDL . L oNgS LeeveC ottoND erByt eeS@ $22( SIzeSS,M,L & xL):( PLeaSe INDICate NuMBer&SIzeS ): SM ______ MeD ______ Lg______ xL ______$a DDL . L oNgS LeeveC ottoND erByt eeS@ $24( SIzeSxxL & xxxL):( PLeaSe INDICate NuMBer&SIzeS ):xxL______ xxxL ______$P erForMaNCe(D rI -F It ) L oNgS LeeveD erByt eeS@ $35( SIzeSS,M,L & xL):( PLeaSe INDICate NuMBer&SIzeS ): SM ______ MeD ______ Lg ______ xL______$P erForMaNCe(D rI -F It ) L oNgS LeeveD erByt eeS@ $37( SIzeSxxL & xxxL):( PLeaSe INDICate NuMBer&SIzeS ):xxL______xxxL______$*Shirt sizes are not guaranteed unless entries are received by Dec. 20, 2019. TOTAL REMITTED: $Participants of the Silver Sailfish Derby enter at their own risk.By entering, I agree that the WPBFC, sponsors, committee members & all persons connected directly or indirectly with the operation of the tournament shall be exempt from any liability for loss, damage, negligence, harm or injury suffered to any participant, vessel or equipment which may occur during the tournament.All anglers aboard my boat understand the rules of the tournament & agree to abide by them.* Sorry, No rain checks or refunds. Signature of Registrant:Return this form to: Derby Entry, P.O. Box 468, WPB, FL 33402 or fax to (561) 832-2137register online at: westpalmbeachfishingclub.org/silver - sailfish - derby.php'