Team Member 1

Team Member1 Name:

First

Last

Team Member1 Address:

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Country

Team Member1 Phone:

Area Code

-

Phone Number

Team Member1 E-mail:

Date:

Team Member 2

Team Member2 Name:

First

Last

Team Member2 Address:

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Country

Team Member2 Phone:

Area Code

-

Phone Number

Team Member2 E-mail:

Boat Year:

Boat Make:

Boat Model:

Motor Year:

Motor Make:

Motor Model:

How did you hear about the GRAHA Walleye Shootout?

Team Sponsor:

Registration fee: $430.00 per two person team.

Along with your registration you must also pay your entry fee in advance.

Upon clicking submit you will be redirected to PayPal, where you can pay your entry fee using your credit card or your PayPal account.

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