Fishing School For Kids Registartion Form

North Captiva Charters Fishing Day School
Registration Form
Student ________________________________AGE________________
Contact Information (Please Print Clearly)
Parent/Guardian Name: ___________________________________________________
Island Address ____________________________________________________________
(NCIC HOUSE #)__________________ (SAFTEY HARBOR #) ___________
Phone Numbers:
(ISLAND HOUSE#) ________________________
(CELL#) __________________________
Name of individual(s) authorized to pick up child if not
Parent/Guardian: ____________________________________________
Secondary Contact Information (If parent/guardian cannot be reached):
Name_______________________________________________Relationship:______________
Phone (CELL#)________________________

If you have any question or for advance registration,please call 239-707-9701 or email Gretchen @gretchenfalk@yahoo.com . A minimum of 4 students and maximum of 6 students allowed each day. You will be notified the night prior to the school if there are not enough students enrolled in the class.

North Captiva Charters, Inc.

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