Northern Manitoba Walleye Championship online entry form

Captain Name:*
Mailing address:*
E-mail address:*
Gender:*

Partner Name:*
Partner Mailing address:
Partner E-mail address:
Partner Gender:*
Boat Make and Model:*
$250 Entry fee. Check one:*
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.*
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