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. *

Crescent Lake Derby | June 27th

Odell Lake Derby | August 8th

Please select a derby.

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

Total Non-Member Anglers

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

All participating non-motorized boats are required to possess a Waterway Access Permit and all out of state motorized boats require an Aquatic Invasive Species Prevention permit. These can be purchased online at www.boat.oregon.gov/store or through the ODFW app.

Marine Board Rules

To prevent the spread of aquatic invasive species, inspect boats to ensure that there are no aquatic organisms on the hull, trailer, motor or other boating-related equipment or gear. As needed, participants must carefully and completely clean their boats away from the water and re-inspect before launching.

Online Payment

Captcha *

For security verification, please enter any random two digit number. For example: 79