Derby Mail-in Payment Entry Form



 

Please select a derby
Please enter the Boat Captain's Name.
Select Membership ( If you have not paid for the current year's membership then choose the Non-member and this will include the membership fees for this year)
Select Membership ( If you have not paid for the current year's membership then choose the Non-member and this will include the membership fees for this year)
Select Membership ( If you have not paid for the current year's membership then choose the Non-member and this will include the membership fees for this year)
Select Membership ( If you have not paid for the current year's membership then choose the Non-member and this will include the membership fees for this year)
Angler's Lunch is included in the entry fee
One per team.

After your registration is submitted, you will receive an email with your registration information. Please print out and mail the registration along with your payment to:
Kokanee Power of Oregon
PO Box 989
Philomath, OR 97370

Please enter the Total displayed above here before submitting.