WASHINGTON STATE "Outdoor
Life"
SAMBOREE at MOSES LAKE, WA. |
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June 3, 2010 to JUNE 5, 2010 |
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REGISTRATION
FORM |
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Last Name |
His First |
Her First |
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Address |
City |
State/Zip |
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Home Phone |
Chapter |
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Good Sam No. |
Exp. Date |
Handicap Permit No. |
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Registration Fee |
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Postmarked Before |
Postmarked After |
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Payment Due |
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5-19-10 |
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5-19-10 |
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1 Rig ( 2 Persons) |
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$73.00 (US Funds) |
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$80.00 (US Funds) |
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$ |
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1 Rig (1 Person) |
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$60.00 (US Funds) |
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$68.00 (US Funds) |
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$ |
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Extra Person (12
& over) |
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$10.00 Each Person |
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$10.00 Each Person |
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$ |
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(US Funds) |
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(US Funds) |
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Extra Night |
Wed. |
$18.00 Each Night |
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$18.00 Each Night |
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$ |
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6/2/10 |
(US Funds) |
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(US Funds) |
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SCRAMBLE GOLF |
By May 1, 2010 |
After May 1, 2010 |
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| Player #1 | Player #2 | ||||||||||||||||||||||||
| Player #3 | Player #4 | ||||||||||||||||||||||||
Make Check Payable To: Washington State
Good Sams
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Total |
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We understand the Washington State Good Sam
Organization has taken reasonable safety precautions and we accept full responsibility for
the welfare of our units and all persons in our unit while attending the Washington State
Samboree. |
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Date Received |
Check
No. |
Total |
Owe |
Need Refund |
Check |
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Date |
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Cash |
Initial |
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If you would like to volunteer and help at this campout please check box.
RV PARKING 8:00 AM to 5:00 PM ONLY
NOTE: No Dinner will be served on Saturday Night as previously indicated in the Happy Wheels.
From the west on I-90 take exit 176. At
stop sign turn left on to W. Broadway, follow to N. Stratford and turn left. Go to W.
Valley Road and turn left. The fairgrounds will be approximately 1 mile on your right.
Turn right at Airway Drive and entrance is on your right.
From the east on I-90 take exit 179 go
right on to S. Pioneer, follow to N. Stratford and turn right. Go to W. Valley Road and
turn left. The fairgrounds will be approximately 1 mile on your right. Turn right at
Airway Drive and entrance will be on your right.