Kentucky Taxidermists Association
Annual Convention and Competition Registration
2012
Competition Registration
Need more info about the convention ? contact convention@kytaxidermy.com
2012 Kentucky Taxidermists Association
Annual Convention and Competition Registration

                                                               Price      QTY        Total $
Per-registration fee                                               $75.00                $  _____
(Includes one Banquet Ticket and one entry)
Late-Registration fee (after July 10th )           $100.00                  _____      
Additional Banquet Ticket (Each)                         $25.00     ____       _____             
Best All-Around Commercial Taxidermist              $15.00                   _____
Best All-Around Professional Taxidermist             $15.00                   _____              
Best All-Around Master Taxidermist                      $15.00                   _____               
Best Original Creation (Each Mount)                    $15.00                   _____               
Habitat Catagory   (Each Mount)                          $10.00    _____     _____              
Amateur Division  (Each Mount)                           $10.00    _____      _____              
Commercial Division  (Each Mount)                      $10.00   _____       _____               
Professional Division     (Each Mount)                  $10.00   _____       _____               
Masters Division   (Each Mount)                           $10.00   _____       _____              
Membership Fee (required to participate )            $60.00                    _____               

Collective Artist Division                                        $30.00    ____        _____             
Affiliate membership                                              $10.00    ____        _____      
* see rule below
Presidents Challenge                                           $10.00                    _____

                                                                                 Total ____________
Name _______________________________________________
Address _____________________________________________
Telephone ___________________________________________
Email _______________________________________________

*** Call Wade Calvert for information on awards. (502) 867-9997

I agree to abide by the competition rules established by the Kentucky Taxidermist Association.  I am Participating
at  the KTA
Convention and Competition at my own risk and hereby release KTA and all members ” from liability of handling
mounts,
damage or theft of mounts entered in the competition and from accidental Personal injury".

Signed:______________________________________________________

+  Affiliate membership is only available to immediate family members of a paid KTA regular member.
(ie: spouse,dependant children residing in the same household)

All Pre-Registration fees must be postmarked by July 10th.  Make checks payable to; KY Taxidermist
Association.

Please send Pre-Registration forms and fees to:
Brian Bliese • 5010 Prosperity Lane • Hopkinsville, KY 42240 • Phone # 270 885-7468

Please list  number of each type mount  ...
wall mount________  Table mount_________    Pedestal______________