2019 Northern Manitoba Walleye Championship online entry form

Captain Name:*

First

Last

Mailing address:*

Street AddressCityProvince/StatePostal / Zip Code

E-mail address:*

Gender:*

Male

Female

Partner Name:*

First

Last

Partner Mailing address:

Street AddressCityProvince/StatePostal / Zip Code

Partner E-mail address:

Partner Gender:*

Male

Female

Boat Make and Model:*

$300 Entry fee. Check one:*

Interac e-transfer

In Person

By agreeing, I acknowledge that my name, likeness, and performance in connection with the Northern Manitoba Walleye Championship may be used to promote, publicize, or otherwise report on the results. I acknowledge that I have read the rules of the NMWC and fully understand them. I acknowledge that the NMWC is not liable for any death, injury, damage, fire, theft or loss that may result prior to, during or after the tournament howsoever caused.*

I agree

If paying by:

Interac e-transfer – email payment to kickerfish.ca@gmail.com (Include full name in email. Text full name and transaction password to 204-995-6583)

In Person – call or text Eric at 204-995-6583 or Dino at 204-228-3622 to arrange

Northern Manitoba Walleye Championship page