Online VIP Participant and Group Application

Lions VIP Fishing Tournament | Outer Banks, NC

The 2023 VIP Fishing Tournament will be October 16-18, 2023!

Directions:

The number of applicants will be limited to 500 and will be accepted on a first-come, first-serve basis.
Each person attending must fill out a separate application. This includes all drivers, workers, spouses, volunteers and guides requiring accommodations. Otherwise rooms are not guaranteed.
Forms must be filled out completely and signed or they will be returned and you will then be put in order of acceptance according to the date of the next submission.
Local transportation and the coordination of this transportation is the responsibility of the group leaders and participants.
No alcoholic beverages or illegal drugs may be in a participant’s possession or consumed by a participant while participating in the event. Any participant found violating this regulation will be sent home.
If there are any accidents or medical needs while at the tournament you are required to call 252-202-2329.
Entering your name and clicking Submit on the form indicates your acceptance of these terms, and is your legally binding signature for this application.
By entering my name and submitting this online application, I, the undersigned do hereby release and discharge the NC Lions VIP Fishing Tournament, and any of its agents, affiliates, employees, and servants from any and all claims, liabilities, demands, or rights which I, or any of my friends or relatives, may have against said Tournament or its agents, affiliates, employees, or servants on account of connecting with or growing out of any injury, accident, loss, or damage or suffering, I or my immediate family may hereafter sustain arising out of acceptance of this application.
By entering my name and submitting this online application I further agree to release to the VIP Tournament all rights and privileges to photographs taken of me for use in VIP Fishing Tournament publicity that is in the proper interest of the Tournament.
By entering my name and submitting this online application I attest that I have read, or caused to be read to me, the foregoing and do hereby acknowledge that I fully understand each and every part thereof. I acknowledge these regulations and agree to abide by them.

Fees:

Fees are $100 if you are visually impaired and $125 if you are sighted
Fee includes three nights lodging, (Mon., Tues, & Wed.) six meals, fishing and educational workshops.
After submitting application you will be directed to make payment of $100 for VIPs and $125 for sighted via paypal on our website. If you prefer, you may write a check, payable to VIP Fishing Tournament, Inc.
Mail check to: Gwen A. White, Executive Director, P O Box 140, Columbia, NC, 27925.

Name For Badge

First Name *
Last Name *
Nickname
Are You a Lion?
If so, which club?

Contact Information

PO Box or Mailing Address *Where you get mail
County *County where you live
City *
State *
Zip Code *
Home Phone *
Work Phone
Cell Phone
Email Address *(no information will be shared with anyone)

In case of emergency, call:

Name

Home Phone

Work Phone

Personal Information

NOTE: Used only for statistics and emergencies - your information will not be shared.
Date of Birth *
Age *
Gender *
Your Vision *
List any medical problems and/or medications taken on a regular basis.
Do you use a wheelchair or a walker?
Select Your Preference
Do you have a hearing problem?
Do you need to borrow a free assisted listening device from the Division of the Deaf and Hard of Hearing ?
Are you a diabetic?
Do you have special equipment or dietary needs?
If so, what special equipment or dietary needs?
Who is providing your transportation? You should arrive between 3 and 5 p.m. on Monday. Hotels may not be ready for check-in before then.
What County?

Your Preferences

Your fishing preference We will make every effort to meet your request, but since the number able to fish on a boat is limited we make no guarantees.
Who is your choice for a roommate?
There could be several people to a room.
If you are placed on the waiting list what is your preference?
Have you attended before? *
How many years?
If you have a question you would like the Doctor to answer in Wednesday's session, please enter it below.