On Line Registration Form To Print And Fill Out

North Carolina Good Sam

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On Line Registration Form To Print And Fill Out

NORTH CAROLINA SPRING SAMBOREE
APRIL 27 - 29, 2012
TOM JOHNSON RALLY PARK
MARION, NC 28752

Full Name:

City/State/Zip

Email address/Phone:

Chapter / GS #:

CANCELLATION FEE: A fee of $10.00 will be charged for cancellation prior to April 1st. After April 1st, the cost of each meal($8.50)will be added to the $10.00 fee.

Request information on:



Motor Home__ Travel Trailer__ Fifth Wheel__ Van Camper __ Pop Up__ Length_______

The submission of this registration form for the North Carolina Samboree acknowledges that I accept full responsibility for the welfare of our unit and all persons in our unit while attending the North Carolina Samboree.

Weekend Fee: 2 Nights Camping: 2 Adults: Pre-Registered by April 1st: (Saturday Meals Included) $70.00 $ AFTER April 1st and at Gate: $80.00 $ 1 Adult: Pre-Registered by Sept. 1st: $62.00 $ AFTER April 1st and at Gate: $72.00 $ Extra Adults and Children over 6 # @$8.50 Early Bird Starting Monday: Number of Nights ___ @ $25.00 $ Tom Johnson Campground Across The Road 50amp Add $10.00 Per Night # @ $10.00 $ Golf Cart Rental Per-Day: # @ $50.00 $ Golf Carts Must Be Pre-Paid With Registration: TOTAL REGISTRATION ENCLOSED: $

Teens # Under 6 # 1. 2. 3.

FULLY HANDICAPPED? YES # Handicap Parking will not be with your chapter.

All Campsites Are Full Service 30amp

The submission of this registration form for the North Carolina Samboree acknowledges that I accept full responsibility for the welfare of our unit and all persons in our unit while attending the North Carolina Samboree.

MAKE CHECK PAYABLE TO: NC State Good Sam Fund