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)
A $10.00 discount has been applied for each team member for entries postmarked or submitted online 2 weeks before the date of the derby. Detroit before 4/10, Wickiup before 5/29, Odell before 7/31.
A $10.00 discount has been applied for each team member for entries postmarked or submitted online 2 weeks before the date of the derby. Detroit before 4/10, Wickiup before 5/29, Odell before 7/31.
Angler's Lunch is included in the entry fee
One per team.
COVID-19 The box below must be checked in order to complete the derby application. If you are not comfortable checking this for all your team then you can have each individual fill out their own application as this acts as your signature. Just have each team member list the same boat captain.

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
3306 Antigua Ln SE
Salem,OR 97317

 

Please enter the Total displayed above here before submitting.