Arkansas Fall Samboree *** THE RIVERBOAT GAMBLER ***
October 7, 8, 9, 10, 2010
AR/OK State Fairgrounds, Kay Rogers Park. 4400 Midland Blvd. Fort Smith, AR 72914
You may fill out this form online, print and mail in your pre-registration fees.
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ACTIVITIES: Hospitality- Arts & Crafts- Flea Market- Samgo Cash Prizes- Ice Cream
.......Games Competetion - Commercial Venders - Good Entertainment - Golf Scramble
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FACILITIES: Limited Electric & Water - Dump Stations & Showers
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PARKING: Early Bird Parking $12.00 per night, payable when registering, you may arrive as early as
1:00PM Monday, October 3, 2010. Come together, Park together. You will be parked by the State
Wagon Master and his Staff. A holding area is available outside the gate on 50th Street prior to Parking.
--------------------------------------------------- REGISTRATION FORM ---------------------------------------------------
Pre Reistration must be received by October 1, 2010
First NameSpouse's NameLast Name Street AddressCity State/ProvinceZip/Postal CodeHome Phone E-mail Enter your Good Sam member number: Expiration date: Enter your chapter name. Is this your first Samboree? Yes No
Is this your first Arkansas Samboree? Yes No
Enter children's names & ages (under 18-no charge).
Please refer to the appropriate Samboree fee amounts below:
1 Rig with 2 Adults, Pre-Registered.............................. $60.00
1 Rig with Single Adult................................................... $55.00
Each Additional Adult.................................................... $15.00
(If not Pre-Registered will add $5.00)
Enter the amount for each additional person over your rig fee:
Enter the total fees included with this pre-registration form:
Make check payable to: Arkansas Samboree
Mail form to:
Melinda Wiggs, Registrar
2501 Skyline Point
Jonesboro, AR 72404
870-972-0951
mwiggs2501@yahoo.com By your signature you understand and you agree to abide by the terms and conditions indicated below.
I/WE understand the Arkansas Good Sam Organization has taken reasonable and necessary precautions and, therefore,
I/WE accept full responsibility for the welfare of my/our unit while attending the above indicated Arkansas Samboree.
The Arkansas Good Sam reserves the right to refuse registration and/or admittance to anyone.
