OPENING WEEKEND TROUT JACKPOT 3rd - 4th October 2026
Fill out the form carefully for registration
Skipper Full Name
First Name
Last Name
Email
Email Address
Phone Number
Mobile Number
Team Name
Boat Name
Boat Make and Size
Boat VHF Number
Please make payment to Bank Account 02-0488-0034035-026
use boat name and surname reference
Angler Section - Trout Jackpot
Rows
Full Name
Membership #
Club Name
Section
Angler 1
SM
SF
JM
JF
Angler 2
SM
SF
JM
JF
Angler 3
SM
SF
JM
JF
Angler 4
SM
SF
JM
JF
Angler 5
SM
SF
JM
JF
Angler 6
SM
SF
JM
JF
Angler 7
SM
SF
JM
JF
My Products
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Jackpot entry
per Angler
$10.00 NZD
$
10.00
NZD
Quantity
1
2
3
4
5
6
7
8
9
10
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Skipper's Signature, by signing I acknowledge I have read and agree to Rules of this tournament.
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