PERSONAL INFORMATION
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| Name:_________________________________ |
| Address:_______________________________ |
| City, State, Zip: _________________________ |
| Home Phone:(_______) __________________ |
| Work Phone: (_______) __________________ |
| Cell Phone: (_______) ___________________ |
| Fax Number: (_______) __________________ |
| Email: ________________________________ |
| Year of Birth: __________________ |
| Business Name: ________________________ |
| T-Shirt Size: S M L XL XXL (Circle One) |
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PAYMENT INFORMATION
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| Payment: ___ Visa ___ MC ___ Discover ___ Check |
| Credit Card# ______________________ |
| Exp. Date: ________________ |
| Name on Card ______________________ |
| (please print) |
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Number of people in party:______________Other Party Members Names:__________________________________________________
________________________________________________________
___Yes, my company would like to be a SPONSOR/donor. Please contact me! |
SEMINAR REGISTRATION
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Weekend Seminar Registration includes, meals, goody bag, t-shirt and more!
$160 Registration Fee |
| FISHING ADVENTURE INDIVIDUAL REGISTRATION (optional) |
Islamorada Full Day 8 Hour Fishing Rates:
(Rates are per person. Coming alone? Don't worry, no need to fill the boat, we do it for you!)
$______ $55 - Fishing from Party Boat (9:30am-1:00 pm, gratuity not included)
$______ $330 - Bay/Flats Fishing Boat
(2 persons/per boat, 7am-3 pm, 8 hours, gratuity not included)
$______ $220 - PRICE ROLLBACK! Large Sportfishing Boat
(6 persons/boat, offshore, 7am-3 pm, 8 hours, gratuity not included)
Need help deciding which boat category? Just click here! Fishing Adventure prices subject to change based on increasing fuel prices.
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TOTAL AMOUNT ENCLOSED
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$ 160 Registration Fee |
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$ _____ Fishing Adventure Price |
| = |
$ _____ Total Enclosed |
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ACCOMMODATIONS
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Seminar cost does not include hotel accommodations. If you plan on staying you are responsible for making arrangements. LLGF suggests our host hotel:
Breezy Palms Hotel
305-664-2361
$69-$149 per night
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I,__________________________ , participate in the organization known as "Ladies, Let's Go Fishing!", which engages in sport fishing and other recreational outings. For and in consideration of the reciprocal release of other participants of "Ladies, Let's Go Fishing!" to me and for other good and valuable consideration to me, including my right to participate in the activities of "Ladies, Let's Go Fishing!", I, the undersigned, for and on behalf of myself and my heirs, successors, and assigns, assume sole and exclusive liability and release "Ladies, Let's Go Fishing!" and its sponsors and participants ("Released Parties") from liability for any damage to my person or property that I may incur as a result of or in the course of any activities of "Ladies, Let's Go Fishing!".
It is specifically understood and agreed that this Liability Acknowledgement and Waiver Of Claims includes, but is not limited to, any and all claims, which I may have against the Released Parties, or any of them, whether such claims are based upon tort, contract, common law, and/or statutory law.
I agree not to institute or assist others in instituting any action against Released Parties for or because of any incident or event occurring prior to the date of this Liability Acknowledgement and Waiver Of Claims.
I declare that I have fully read the foregoing Liability Acknowledgement and Waiver Of Claims in its entirety and that I have been fully advised by my attorney or have had an opportunity to receive advice from an attorney, prior to executing this Liability Acknowledgement and Waiver Of Claims, and that I know and understand the contents hereof and have signed the same as my own free, intelligent, and voluntary act.
Signature:___________________________________________________
Print Name:__________________________________________________
Witnessed by:________________________________________________
Date:_______________________________________________________
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Cancellations must be made by the Friday at 5PM Eastern time, two weeks prior to the event for a refund. There will be a a $10 deduction for cancellation of reservations made by credit card. Registrants who do not attend and do not cancel by the Friday two weeks before the event will be assessed the full program fee. You may send a substitute. Fishing trip must be paid in advance to hold space. You will receive directions to the seminar, attire suggestions & other tips. Recommended age 21 and up. I have read and agree to the cancellation policy.
Signature ____________________________________________________
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