Destin Cobia TournamentEntry fee

$471.70 + 6% = $500.00

Date Entered ____________________________________ Boat _________________________________________

Captain _________________________________________

Owner _________________________________________

Address _________________________________________

_____________________________________

Email _________________________________________

Phone _________________________________________

I, ____________________, do hereby release, discharge and hold harmless HarborWalk Marina, and its employees and volunteers from any claim for damages to my person or property incurred by my participation in this event. This release also applies to all crewmembers and individuals on my boat.

Office use onlyForm of Payment__________Employee Name___________T-Shirt Sizes___ ______

Ditty Bag Yes_____No_______ *Two long

sleeve per boat entry

Destin Cobia Tournament Optional

Calcuttas

Big Fish Calcutta (please circle)

$100 $250 $500 $1000

Boat _________________________________________

Captain _________________________________________

Total $__________Method______________________

**HWM rep initials___________