Boat Captain Registration Form

By completing this form, you acknowledge that the Pillager Huskies Fishing Team is not responsible for any injuries that may occur and hereby assume any risks involved with participating in this activity.

I grant the Pillager Huskies Fishing Team the right to take photographs of me and my property. I agree that they may use such photographs, with or without my name, for any lawful purpose including publicity, advertising, and web content.

Fields marked with an * are required.

First Name *

Last Name *

Address Line 1 *

City *

Postal Code *

Date of Birth *

Phone *

Email *

Boat Make/Model *

Boat Length *

Motor *

HorsePower *

What size motor is your boat rated for?

Insurance Provider

Policy #

Do you have a live-well in your boat? *

Please verify that you have checked the “I'm not a robot” checkbox.