|
|
|
|
|
VENDOR -------- VENDOR -------- VENDOR-------- VENDOR -------- VENDOR
REGISTRATION FOR MISSISSIPPI FALL SAMBOREE
MID-SOUTH RV PARK & CONVENTION CENTER
111 RESORT VILLAGE RD, TUNICA RESORTS, MS 38664
SEPTEMBER 30- OCTOBER 3, 2010
ACTIVITIES
HOSPITALITY, GAMES,ARTS & CRAFTS, RAFFLES, SEMINARS, ENTERTAINMENT
DOOR PRIZES ,CAKE WALK, SAMGO ,GOLF TOURNAMENT, CHURCH SERVICE
OUR THEME WILL BE "Magnolia Mardi Gras"
THURSDAY through SATURDAY MORNINGS Pastry, With COFFEE
WATER, ELEC. 30/50, Sewage, WiFi, & SWIMMING POOL AVAILABLE
(Bring extra water hose with "Y" & Electric Cords)
Holding Area with full service after 5:00 PM Arrival
MAKE CHECKS PAYABLE TO: GOOD SAM CLUB OF MISSISSIPPI
MAIL REGISTRATION FORM & CHECK TO: Registrar:
Bobbie Smith, 109 Sherrills Ln. Brandon, MS39047, Bo1El2@aol.com Ph: 601-829-1883
________________________________- (CUT ON LINE) _______________________________
Tables IF available - - NO GUARANTEE Tables IF available - - NO GUARANTEE
SAMBOREE FEE INCLUDES: 2 PERSONS, 3 NIGHTS ------------------------------- $ 75.00
CATERED MEAL: Number of plates____ @ $15 ea ------------------------------------ $______
ADDITIONAL PERSONS: $10.00 EACH -----------------------------------------------------$______
IF NOT PRE-REGISTERED,FEES WILL BE $5.00 MORE AT ARRIVAL ------------ $______
EARLY BIRD PARKING Sept. 28-29 please pay the RV Park
ADDITIONAL BOOTH (10' X 10' ) ________ @ $50 ea ----------------------- $ ______
Your canceled check is your receipt TOTAL ENCLOSED $ ______
*** Cancellation Fee (Non Refundable) $ 5.00
***PRE-REGISTRATION DEADLINE POSTMARKED NO LATER THAN Sept. 18, 2010***
Good Sam # _________________________________________
NAME__________________________________SPOUSE_______________________________
PLEASE PRINT
ADDRESS________________________________E-MAIL_______________________________
CITY___________________________________________STATE_______ZIP_______________
HANDICAP PARKING YES _____ NO _____ *OFFICIAL # ____________________________
TELEPHONE NUMBER (____) _______________CHAPTER___________________________
FIRST TIME TO A MISSISSIPPI SAMBOREE ? YES_________ NO__________
Products for Sale: _____________________________________________________________
NOTE: We the undersigned, understand the Mississippi Good Sam Organization has taken reasonable and necessary precautions; therefore we accept responsibility for our units and all occupants, while attending this Samboree.
SIGNATURE __________________________________________________________
* Requirement
Form 050310
|
|
|
|
|
|
