Golconda City Planning Commission

Oasis on the Ohio Boat Poker Run

Oasis on the Ohio Registration

Captain Information

First Name

Last Name

Phone/Mobile

Address Line 1

Address Line 2

City

State

Zip Code

Country

Date of Birth

Boat Information

Boat Name

Make of Boat

Length of Boat

Boat Horsepower

Boat Registration Number

Boat Insurance Information

Insurance Company

Policy Number

Policy Expiration Date

I have read and understand the following:

Please adhere to IDNR boating laws and regulations as Conservation Officers could be out on the waters with us. Stay safe and have fun!

The City of Golconda, Golconda City Planning Commission, Golconda Marina, officers, employees, members, and volunteers are not liable for any damages, injuries, or losses that may occur during the Boat Poker Run. By signing the above registration form, I agree to hold harmless any of the aforementioned entities and individuals of any incidents that may occur and am guaranteeing all information to be true and correct.

Payment for Poker Hand(s)

Oasis on the Ohio Registration Fee (Pay via PayPal):

$30.00

Initial Registration Fee

This fee is paid via PayPal and you will be directed to the site when you hit submit. It includes:

1 Poker Hand
1 Dinner

Additional Hand(s)

Price: $20.00

Number of additional hand(s)

Additional Dinner(s)

Children under 12 dinner

Price: $5.00

Number of children’s dinner(s)

Additional Adult Dinner

Price: $15.00

Number of additional adult’s dinner(s) without Poker Hand(s)

Contact Us

Golconda City Planning Commission

FaceBook essayons1929@gmail.com