Registration - Alabama District Rally

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Name

Last

First

M/F

DOB

Veh.

GW#

Exp.

Name

Last

First

M/F

DOB

Veh.

GW#

Exp.

Name

Last

First

M/F

DOB

Veh.

GW#

Exp.

Name

Last

First

M/F

DOB

Veh.

GW#

Exp.

Address

Street

City

State

Zip

Phone

Chapter

Distrct/Region

District

Region

National

Staff Position

Distance

Miles to Rally

Calculate-Distance

Registration

$25 x

GWRRA Member

Total

$30 x

Non-Member

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

Rally Polo Shirts

$18 x

2XL

Total

$20 x

3XL

Total

Rally Long Sleeve TEE

$16 x

2XL

Total

$18 x

3XL

Total

Rally Short Sleeve TEE

$14 x

2XL

Total

$16 x

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 500 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 prior to March 15, 2009

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