Your Name (required)

Address (required)

Your Email (required)

Telephone Number (h)

Telephone Number (w)

Cellphone Number

Number of people

Please indicate preferred fishing partners

BANKING DETAILS
ACCOUNT NAME: Queenstown Flyfishing Club or QFFC
BANK NAME: First National Bank Queenstown
BRANCH CODE: 210920
ACCOUNT NUMBER: 53530055160
REF: Initials and Surname

USE YOUR INITIALS AND NAME AS REFERENCE ON DEPOSIT SLIP/PROOF OF PAYMENT.

Above fees exclude Any accommodation and should be arranged directly with Aloe Grove
Contact No: 045 8395910 or 045 8395943

COMPLETE FORM ONLINE AND EMAIL PROOF OF PAYMENT TO eboucher@telkomsa.net – LIMITED ENTRIES AVAILABLE

I the undersigned hereby agree to abide by the rules of the Queenstown Fly Fishing Club and are aware that any contravention of these rules could result in legal action being taken against me and any other persons present with me at any of the club waters.

I agree