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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
SATURDAY NIGHT CATERED DINNER
WATER, ELEC. 30/50, Sewage, WiFi, & SWIMMING POOL AVAILABLE
(Bring extra water hose with "Y" & Electric Cords)
Holding Area with full service 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, CATERED DINNER FOR 2 --------- $ 75.00 .
ADDITIONAL MEALS: (ALL AGES) __________@ $15.00 EACH ------------------------------- $ _____ .
ADDITIONAL PERSONS: $5.00 EACH ------------------------------------------------------------------- $ _____ .
IF NOT PRE-REGISTERED,FEES WILL BE $5.00 MORE AT REGISTRATION --------------- $ _____ .
EARLY BIRD PARKING Sept. 28-29 @ $17.00 PER NIGHT-- PAY AT Registration Desk --- $ _____ .
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 011410
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