Registration - Alabama District Rally

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Name

Last

First

Transport

Type

Count

Veh.

First-Timer

M/F

DOB

GW#

Exp.

Name

Last

First

Transport

Type

Count

Veh.

First-Timer

M/F

DOB

GW#

Exp.

Address

Street

City

State

Zip

Phone

Distance

Miles to Rally

Calculate-Distance

Chapter

Distrct/Region

District

Region

National

Staff Position

Registration

$30 x

Members

Total

$35 x

Guests

Total

Tickets

1 Ticket $1, 6 Tickets $5 x

Grand Prize

Total

4 Tickets $1 x

Door Prize

Total

20 Tickets $10 x

50/25/25

Total

Classes

$50 x

ERC

Total

$50 x

TRC

Total

$25 x

CPR

Total

$25 x

First-Aid

Total

Rally Polo Shirts

$20 x

Total

$22 x

2XL

3XL

Total

Rally Long Sleeve TEE

$18 x

Total

$20 x

2XL

3XL

Total

Rally Short Sleeve TEE

$16 x

Total

$18 x

2XL

3XL

Total

Payment

Check #

Payable to: Alabama GWRRA

Fully Paid Registration:

Includes: Door Prize ticket, Dinner ticket, Ice Cream Social, Rally Pin per person. Note: Rally pin guaranteed to the first 300 pre/full registered!

Awards

Must be fully registered to win awards and prizes, and to participate in Rally activities. Must be present to win grand prizes and awards. All awards (except onsite events) are tabulated from pre-registration prior to Rally.

10% Cancellation fee after March 15, 2010

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