2011 Kansas Fall Samboree Pre-Registration
Oct 6-9.
THEME: ON THE ROAD AGAINIMPORTANT:
No confirmation will be sent; your canceled check will be your
confirmation. Preregistration must be received by September 20th to
obtain the below fees.
Last
Name__________________________________________First____________________Spouse__________________
Address_________________________________________________City___________________State_____Zip_________
Phone________________________________Chapter_______________________________________________________
Good Sam
Number___________________________________________________Expiration
Date___________________
Prices
You can also register at
the Samboree for an additional $10.00 |
|
| o
1 RIG w/2 Adults |
|
$60.00 |
|
$________ |
| o
1 RIG w/1 Adult |
|
$50.00 |
|
$________ |
| o
Additional Persons, 12 & over |
|
$20.00 |
|
$________ |
| |
|
____________________ |
| |
|
Total |
|
$________ |
|
NOTICE:
There will be a $10.00 cancellation fee for
cancellations after Sept 20th.
Cancellations must be in writing. No refunds for no-shows.. |
Early Bird Parking
$15.00 per night Payable at
Registration Desk |
|
|
Golf
Number of players ________
Golf cart
o Yes
o
No |
|
Help Us
First time at Samboree?
o
Yes o
NoFirst time at Kansas
Samboree?
o Yes
o
No
If you don’t belong to a Kansas
chapter, would you be interested in joining one?
o
Yes o
No |
|
Make Checks Payable to:
KANSAS STATE SAMBOREE
Print and Mail Registrations to:
Marty Ward, Samboree Registrar
2201 E MacArthur E-3
Wichita, KS 67216-5614
E-mail:leward2@cox.net
Phone: 316.213.8297
I (We) the undersigned understand the
Kansas Good Sam Organization has taken reasonable and necessary safety
precautions and I (we) accept full responsibility for the welfare of my
(our) unit(s) and all persons in our units while attending the Kansas
Samboree.
SIGNATURE____________________________________
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