SEA SHELL BEACH CLUB

SEA SHELL BEACH CLUB'S

10^th ANNUAL

STRIPED BASS DERBY REGISTRATION FORM OCT. 27^th,28^th, 29^th, 2006

BOAT NAME:___________________________

Shirt Sizes: Angler #1_____, #2_____ #3____ , #4_____, #5_____,#6____, #7 ____

HOME MARINA:___________________________

BOAT LENGTH:___________ BOAT MAKE:____________

CAPTAIN:_________________________2nd ANGLER:___________________________

ADDITIONAL ANGLERS ($50 EACH): (3)______________________________

(4)_____________________________ (5)______________________________

(6)_____________________________ (7)______________________________

ADDRESS:_______________________________________________

CITY, ST, ZIP:_____________________________________________

PHONE:______________________________

JUNIOR ANGLER (under 17) NAME:__________________________________________

Registration fee $150.00 per boat. This includes entry for two anglers, two commemorative T-shirts, Fri. and Sat. cocktail parties (1 hour open bar, must be 21) and Sunday Fish Fry and awards ceremony. Additional anglers are $50.00 per angler. Please make checks payable to "Sea Shell Club".
Return registration form and check to:

Tom Hughes, Sea Shell Club, 10 South Atlantic Avenue, Beach Haven, NJ 08008

Signature______________________ Date_______________

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Sea Shell Motel Restaurant and Beach Club
10 S. Atlantic Ave.
Beach Haven, NJ 08008
609-492-4611 / Fax - 609-492-2259
Email: shelllbi@aol.com