Xtreme KTS Membership Form

2009/2010 Season Membership Application

Please select: SINGLE ENGINE CLASS OPEN CLASS ELITE CLASS

Name:     Team Name: 

Address: 

City/State/Zip Code:

Home Phone: Cell Phone:

Email Address: Website:

DOB: SSN:

Corporate Name:

F.E.I. #:

Emergency Contact Name:

Emergency Contact Phone/Cell Number:

Boat Manufacturer:

Motor Manufacturer/Type:

I have read the Rules and Agree Disagree to them.

Signature: 

Rules Can Be Read HERE

Membership Class

None Competing Member $75 Elite Series Team (Up to 4ppl) $475 Elite Competing Member $125 Competing Family (Up to 4) $100

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Additional Elite/Family Member

None Additional Elite Competing Member $125 Additional Competing Family Member $25

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Name:   Class:

DOB:   SSN:

Relationship: Type: None Junior Lady Angler

I have read the Rules and Choose Agree Disagree to them.

Signature:

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Name:  Class:

DOB:  SSN:

Relationship: Type: None Junior Lady Angler

I have read the Rules and Choose Agree Disagree to them.

Signature:

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Name:  Class:

DOB:  SSN:

Relationship: Type: None Junior Lady Angler

I have read the Rules and Choose Agree Disagree to them.

Signature:

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Method of Payment - Clich Here to Pay Online

Other Check Enclosed Visa Mastercard American Express

Total $

Check #:  Card #:  Exp. Date:  SEC Code:

I, (as shown on the credit card), authorize Xtreme Kingfish Tournament Series to charge my credit card for 2009/2010 membership fee(s) in the amount shown above. 

Please allow for 4-6 weeks processing to receive your membership.

Additional Comments:

As a member, your privileges include:

Open and Single Engine Class
Single Membership: 
(1) Vote in the Sector you reside in
(1) Vinyl Stickers per paid membership
(1) T-Shirt per paid membership
“Members Only Access” to our website for special discounts on products, services, lodging, fuel and slip rental

Family Membership: 
(2) Votes per team in Sector you reside in
(2) Vinyl Stickers per paid family membership
(2) T-Shirt per paid family membership
“Members Only Access” to our website for special discounts on products, services, lodging, fuel and slip rental

Elite Class
Single Membership:  (1) Vote in Elite Class
Team Membership:  (1) Votes per team in organization
(4) Vinyl Stickers per team paid membership
(4) T-Shirt per team paid membership
“Members Only Access” to our website for special discounts on products, services, lodging, fuel and slip rental

Each membership will expire with the end of the 2009/2010 season, after the XKTS Champions Tournament.

Enter the characters as seen on the image above (case insensitive):


To send via snail mail, Print out page and send to:

United States Kingfish Organization
118 Balmoral Court
Champions Gate, Florida 33896

Click Here to return to the Xtreme KTS main page after the email is successfully send or printed out