BOAT OPERATOR REGISTRATION
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
BOAT INFO
Make Model and Color of boat
*
Size of Boat
*
12
14
15
16
17
18
19
20+
Boat Registration Number ( can be added on derby day )
How many derby guests can you accommodate in your boat (not including yourself)
*
Please indicate how many adults and children
Submit
Should be Empty: