Registration Online

@if($errors->has()) @endif {{ Alert::render() }} @if(isset($error)) @endif @if(isset($ok)) @endif

VAN WORMER RESORTS 18TH ANNUAL EAST CAPE DORADO SHOOT OUT JULY 20, 2024

Team Entry Fee: $600.00 (Maximum 4 Anglers Plus 2 Crew per cruisers / 3 Anglers plus 1 crew per super pangas).

All Teams must check in on July 14th or 15th 4pm-8pm in the convention center at Hotel Palmas De Cortez

{{ Form::open(['route' => 'sign-up', 'role' => 'form', 'method' => 'post', 'class' => 'form-horizontal form-signup']) }}
{{ Form::text('hotel', null, ['class' => 'form-control']) }}
{{ Form::text('boat_name', null, ['class' => 'form-control']) }}
{{ Form::selectRange('amount_of_anglers', 1, 4, null, ['class' => 'form-control', 'id' => 'inputAnglers']) }}
Team captain
{{ Form::text('captain_name', null, ['class' => 'form-control']) }}
{{ Form::email('captain_email', null, ['class' => 'form-control']) }}
{{ Form::text('captain_address', null, ['class' => 'form-control']) }}
{{ Form::text('captain_city', null, ['class' => 'form-control']) }}
{{ Form::text('captain_state', null, ['class' => 'form-control']) }}
{{ Form::text('captain_zip', null, ['class' => 'form-control']) }}
{{ Form::text('captain_day_phone', null, ['class' => 'form-control']) }}
{{ Form::text('captain_eve_phone', null, ['class' => 'form-control']) }}
Angler 2
{{ Form::text('angler_1_name', null, ['class' => 'form-control']) }}
{{ Form::email('angler_1_email', null, ['class' => 'form-control']) }}
{{ Form::text('angler_1_address', null, ['class' => 'form-control']) }}
{{ Form::text('angler_1_city', null, ['class' => 'form-control']) }}
{{ Form::text('angler_1_state', null, ['class' => 'form-control']) }}
{{ Form::text('angler_1_zip', null, ['class' => 'form-control']) }}
{{ Form::text('angler_1_day_phone', null, ['class' => 'form-control']) }}
{{ Form::text('angler_1_eve_phone', null, ['class' => 'form-control']) }}
Angler 3
{{ Form::text('angler_2_name', null, ['class' => 'form-control']) }}
{{ Form::email('angler_2_email', null, ['class' => 'form-control']) }}
{{ Form::text('angler_2_address', null, ['class' => 'form-control']) }}
{{ Form::text('angler_2_city', null, ['class' => 'form-control']) }}
{{ Form::text('angler_2_state', null, ['class' => 'form-control']) }}
{{ Form::text('angler_2_zip', null, ['class' => 'form-control']) }}
{{ Form::text('angler_2_day_phone', null, ['class' => 'form-control']) }}
{{ Form::text('angler_2_eve_phone', null, ['class' => 'form-control']) }}
Angler 4
{{ Form::text('angler_3_name', null, ['class' => 'form-control']) }}
{{ Form::email('angler_3_email', null, ['class' => 'form-control']) }}
{{ Form::text('angler_3_address', null, ['class' => 'form-control']) }}
{{ Form::text('angler_3_city', null, ['class' => 'form-control']) }}
{{ Form::text('angler_3_state', null, ['class' => 'form-control']) }}
{{ Form::text('angler_3_zip', null, ['class' => 'form-control']) }}
{{ Form::text('angler_3_day_phone', null, ['class' => 'form-control']) }}
{{ Form::text('angler_3_eve_phone', null, ['class' => 'form-control']) }}
Optional Jackpots

I want to be charged in

* Information required
{{ Form::close() }}