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                                                             GOOD SAMS OF FLORIDA, INC. 2017 FALL RALLY
                                                                   Parade Theme: “Sam and Samantha on Safari”
                                                        NOVEMBER 15-19, 2017,  EARLY BIRD NOVEMBER 14, 2017
                                                                               SOUTHERN PALMS RV RESORT
                                                             ONE AVOCADO LANE, EUSTIS FL 32726  352-357-8882

REGISTRATION FEE INCLUDES: 4 nights camping with water, electric and sewer. Daily hospitality, Samgo, door prizes,
crafts, parade, flea market, seminars, Rally bars, RV Dealers, vendors, entertainment and MORE.

                                     CANCELLATIONS
There will be a processing fee for all cancellations based on cancellation date:
                 
Prior to September 7th $10.00     September 7th thru October 8th $15.00     October 8th and forward $25.00
                          THERE WILL BE NO REFUNDS FOR “NO SHOWS” (This is if you don’t notify anyone.)
****All cancellations and refund requests must be in writing from YOU and emailed to Tommy Crutchfield, State Director,
or Linda Voyton before the Rally ends. We
Can Not Have Cancellations After The Rally, And Epect To Get A Refund.
NO DEDUCTIONS FOR EARLY DEPARTURE
                                                                WE WILL HAVE CHAPTER PARKING
                NOTE:  
REGISTRATIONS MUST BE IN 14 DAYS PRIOR TO RALLY TO PARK WITH CHAPTER
                    Handicapped spaces will only be provided for our Handicapped members with proper credentials.
                      Please indicate if you want to park with your chapter OR in HANDICAPPED APACES. (NOT BOTH)
                 Unregistered late arrivals may not be parked with their chapter.**Registration 9-5 NO LATE ARRIVALS**

                      ****IMPORTANT!! PLEASE READ!!!   ARRIVE WITH TOWED VEHICLE UNHOOKED***

                                            MAKE ALL CHECKS PAYABLE TO:  GOOD SAMS OF FLORIDA, INC.
                           Please attach a self-addressed stamped envelope for confirmation of registration.
                                          PLEASE RETURN LOWER PORTION OF THIS FORM WITH FEES TO:
                                                     Linda Voyton, P. O. Box 1604, Lutz, FL 33548
                                                    We are looking forward to seeing you at the Florida State Rallies!
                                        Tommy & Lois Crutchfield  850-723-0119    Email:  crutchfieldt01@bellsouth.net
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NAME___________________________________________________            _________________________________________
               Last                                      First                                                              Chapter Name or Handicapped

ADDRESS_____________________________________________________________________________________________  
City and State                                                                                   Zip
Handicapped# ______________________                                         Rig Length ________   Rig Type __________________         
# of Adults   ________    # of Children    _______                                                  (A, B, C, trailer, 5th wheel)

FALL RALLY FEE EUSTIS 2017
PREPAID REGISTRATION   ($135.00)  $___________                               PHONE#______________________________
EARLY BIRD                         ($30.00)   $___________
SINGLE PERSON RIG          ($110.00) $___________                              EMAIL ADDRESS______________________
                                                                (PRINT CLEARLY)
EXTRA ADULT                      ($30.00)   $___________
REGISTRATION AT GATE    ($145.00) $___________
TOTAL FEES FOR RALLY                    $___________

IS THIS YOUR FIRST FLORIA RALLY    YES____  NO____

NOTE:  We the undersigned understand the Florida Good Sam State Staff has taken reasonable and necessary safety
precautions.  Therefore, we accept full responsibility for the welfare of our unit and all persons in our unit while
attending the Florida Rally.

DATE:____________________                        SIGNATURE:___________________________________

             We, Florida Good Sams Inc, reserve the right to refuse any application.
                                                  www.goodsams-florida.org