*First Name:
*Last Name:
*Phone Number:
Where did you hear about this event?

Names of ALL Fishing Rodeo Entrants Fee Category
Number of tickets for additional guests attending Saturday Night Fish Fry ONLY:
($29 each)
HATS ($20 each) and T-SHIRTS ($15) must be pre-ordered.
Orders for hats and t-shirts after June 21, 2013, subject to limited availability.
I request:
I request:
If ordering T-shirts, please indicate sizes:


NO REFUNDS after pre-registration deadline of June 21.
Add $25 per person LATE FEE after
June 21. No exceptions.
Non-refundable credit card convenience fee ($15)

Total amount of fees due to the LDA =
(Please enter your total)

I will pay by: Check or Credit Card

If paying by check, please mail to:
LDA Fishing Rodeo
P.O. Box 261173
Baton Rouge, LA 70826-1173

If paying by credit card,
please enter the information below:

Visa/Master Card Number:
Expiration Date:
Name as it appears on card:
3 digit security code on back of card:

Questions or Comments: