Kentucky Taxidermy Association

2017 Kentucky Taxidermists Association Convention and Competition Registration Form


Please print this page and send to the address at the bottom of the page.

One name will be drawn from all pre-registrants for a free registration the following year.


                                                                                                                                            Price           QTY             Total$

Pre-registration fee..............................................................................................    $75                                   $______

(Includes one banquet ticket)

Late registration fee (after July 18)................................................................$100                                  $______

Additional Banquet ticket (each)........................................................................$25           ______           $______

Best All-Around Commercial Taxidermist.....................................................$20          ______            $______

Best All-Around Professional Taxidermist....................................................$20           ______            $______

Best All-Around Master Taxidermist...............................................................$20          _______           $______

Best Original Creation (each mount)...............................................................$20          _______           $______

Habitat Category (each mount).........................................................................$15           _______           $______

Amateur Division (each mount).........................................................................$15           _______           $______

Commercial Division (each mount)..................................................................$15           _______           $______

Professional Division (each mount)..................................................................$15           _______          $______

Masters Division (each mount)...........................................................................$15           _______          $______

Entry #'s 3, 6, 9, 12 FREE...................................................................................(-$15)          _______          $______

Membership fee (required to participate)....................................................$60                                     $______

Collective Artist Division.......................................................................................$30           _______           $______

Affiliate Membership...............................................................................................$10           _______           $______

   *see rule below

President's Challenge  (this year, anything that swims!)........................$15          _______            $______

                                     

                                                                                                                                                                       Total $___________

Name ________________________________________________

Address ______________________________________________

Phone ________________________________________________

Email _________________________________________________


I agree to abide by the competition rules established by the KTA.  I am participating at the KTA Convention and Competition at my own risk and hereby release the KTA and all KTA 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. (Spouse or dependent children residing in the same household)


All Pre-registration fees must be postmarked by July 18. 

Make checks payable to Kentucky Taxidermists Association or fill in credit card information below.


Card number ______________________________________

Expiration Date____________________________________

3-digit security code_______________________________

Billing zip code_____________________________________

How your name appears on card______________________________________________


Please send pre-registration forms and fees to:

Gary Lizer

1663 Rocky Springs Rd.

Cynthiana, KY  41031

859-954-1267