2012 Poor Boy Open

 September 1, 2012

Entry Form

Name____________________________________________________T-shirt Size________________

Address  ______________________________________________

                   _____________________________________________

Phone Number____________________________________________E-mail___________________

Other Persons Accompanying

Names                                                                                 Females Calcutta $10 extra largest fish caught by a female

1.       _______________________T-shirt Size_______________Females Calcutta_________

2.       _______________________T-shirt Size_______________ Females Calcutta_________

3.       _______________________T-shirt Size_______________ Females Calcutta_________

4.       _______________________T-shirt Size_______________ Females Calcutta_________

5.       _______________________T-shirt Size_______________ Females Calcutta_________

Entry Fee: $50 per angler and includes Barbie rod, Event T-shirt, and food at the check-in provided by Portside Seafood Restaurant

Entries _____By $50(+ $10 for each female entering the Calcutta)=_______________

Extra T-shirts Needed______@$15 each=_____Sizes __________

Extra Meals Needed_______@$12 each=____________________

*****A fishing license is required in Maryland for anyone over the age of 16*****

      *****See the MD DNR website for info on license- free fishing spots*****

Entries Can Be Faxed To Composite Yacht If You Wish To Pay By Credit Card

Entries can also be submitted to:

Poor Boy Open

C/O Composite Yacht

1650 Marina Drive/ Unit A

Trappe, MD 21673

For questions please call 1-410-476-4414 Fax Number 1-410-476-4414

Payment Method__________________________________________________

Date Received____________________________________________________

Received By______________________________________________________