Entry Fee Team

$2,000.00 (Includes 4 person capacity

Individual
$500.00 (You will be placed on a team with a
with guide, Fishing Shirt, gaiter and a Cap.) guide and receive a Fishing Shirt, gaiter and a Cap.)

# Attending Event at Topwater Grill Signature

Number of Teams
I am sorry, but I am unable to participate.
Amount Enclosed Please accept my contribution in the amount
Method of Payment of _____ for Galveston County Senior
Check Payable to Galveston County Citizens Activities, Inc.
Senior Citizens Activities Inc.
Please return entries to:
Visa Master Card
GCSCA, Inc.
Credit Card # c/o Carolyn Sunseri, Tournament Director
6710 Stewart Road, Suite 300
Exp. date Galveston, Texas 77551

Entry Form Live Bait Artificial Bait Either

Team Name
Captain of team Additional Team Members
Captain Name Name

Shirt Size Shirt Size

Company Company

Address Address

City State Zip City State Zip

Office Phone Office Phone

Cell Phone Cell Phone

Alternate Contact Alternate Contact

Phone Phone

Email Email

Additional Team Members Additional Team Members

Name Name
Shirt Size Shirt Size
Company Company
Address Address
City State Zip City State Zip
Office Phone Office Phone
Cell Phone Cell Phone
Alternate Contact Alternate Contact
Phone Phone
Email Email