April 15th - 17th

Paragon Casino

Marksville. LA

RALLY  FEE:

Passport Members RV & 2 people    $ 170.00

Non-Passport Members RV & 2 people  $210.00

Passport Member RV & 1 Person $ 105.00

Non-Passport Member RV & 1 Person $ 135.00

  Additional Person   $ 75.00

Reservation Deadline April 1, 2010

RALLY  FEE  INCLUDES: 

        3 Nights w/Full Hookups,  Hamburger & Chips (Pre-Registeration Wed Eve), Crawfish Boil,

              Two Breakfast Buffets at Casino,  Seafood Buffet at Casino, Saturday Night Dinner,                           Bean Bag Toss Tournament, Joker Tournament , Bingo, Door Prizes, Crafts (Fee),

                                Golf Tournament (Fee),  Pet Contest (Cutest & Smartest)

EARLY BIRD & EXTRA DAYS AVAILABLE.

Mail Reservation Form (Page 2) & Check to:

Fred Walton  (9270)

13030 Bayou Terrace

St. Amant, LA  70774

Questions call Cell: 225-978-1740

Or email:  fredwalton@msn.com

          SCROLL DOWN FOR RESERVATION FORM.

            PRINT PAGE 2 AND RETURN WITH PAYMENT.

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Louisiana State Rally

RESERVATION FORM

NAME_____________________________________________________NKK# ______________________

ADDRESS_____________________________________________________________________________

CITY_____________________________________ STATE______________ ZIP______________________

PHONE: ________________________ E-MAIL: _________________________________________________

UNIT INFORMATION :  MH ___ FW ___ TT ___ Length: ______ # of Slides: ___

PASSPORT AMERICA MEMBER NUMBER_____________________________________________________

DATE OF ARRIVAL____________________________(Pay early days at arrival)

GOLF TOURNAMENT (Thursday AM)  YES__________________  NO________________________________

CRAFTS     YES___________________________ NO_________________________

HANDICAPPED?  YES________  NO___________       DIABETIC?   YES________ NO_________________

Disclaimer: All persons attending a Klub rally must sign this disclaimer in order to participate.

I agree, in consideration for being able to participate in this Newmar Kountry Klub activity, to release and to indemnify and hold harmless Newmar Kountry Klub and Newmar Corporation, its directors, officers and employees, from all liability for injury or damages to my person or property or the property of persons who accompany me to this activity.  With knowledge of the type of risk or harm, which might occur at such activity, I sign this release and indemnify as part of my application.  All adult members and their guests must sign and in so doing, assume responsibility for minors in their care.

Cancellation Policy: I understand and agree to the Cancellation Policy for Rallies, Caravans and Special Events.

Signature:_____________________________________________

Signature:_____________________________________________

Signature:_____________________________________________

Signature:_____________________________________________

(Please print, sign and mail this Disclaimer, with your Rally Fee, to the Rally Host.)

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