Derby Registration (Online Payment)

Derby Online Payment Entry Form

Date

Use One Form for Each Derby Entered - Please fill out all contact information for each team member if they are registering as a non-member. This will be used to send them their membership card and KPO sticker. *

Detroit Lake Derby | Sept 26th

Please select a derby Odell Derby has been cancelled due to COVID issues.

Team Name (Optional)

Captain's Name *

Please enter the Boat Captain's Name.

Angler #1 Name *

Address *

Country

City

State

Zip code

Email *

Phone *

Select Membership *

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 #2 Name

Address #2

Country

City

State

Zip code

Email #2

Phone #2

Select Membership #2

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 #3 Name

Address #3

Country

City

State

Zip code

Email #3

Phone #3

Select Membership #3

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 #4 Name

Address #4

Country

City

State

Zip code

Email #4

Phone #4

Select Membership #4

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)

Entry Fees

Total Member Anglers

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.

Total Non-Member Anglers

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.

Extra Lunch|$10.00

Angler's Lunch is included in the entry fee

Bonus Entrys

One per team.

No Bonus Entry

$10.00 Blind Bogey Entry

$10.00 Biggest Kokanee Entry

$10.00 Biggest Fish Entry - Can be any species.

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.

Must Be Checked *

All participants agree to waive any right to hold the KPO, the KPO Board Members or Shelter Cove and its staff liable for any damages, sickness, or injuries that may arise from the Covid-19 virus whether in compliance or non-compliance of any Executive Order.

By checking this box you agree to the above statement.

Online Payment