2024 Western Regional Muster Registration Form

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Start Date: 2024-03-25       Departure Date: 2024-03-28

Encore Fiesta Grande


Sponsor(s): AZ Roadrunners and AZ Tumbleweeds

Host: Erwin Greven     Phone: (505) 280-0152     Email: egreven123@msn.com


Muster Costs:

Single Cost: $30.00   Couple Cost: $30.00   Couple + Guest Cost: $0.00  

Registration

An entry in all fields shown in the registration form is required.

Pilot:   SMART#:

Copilot:   SMART#:

   

Pilot's Email:

       

In Case of Emergency (ICE) Contact Information

Please provide at least one emergency contact other than your Copilot.

   

   

RV Information

       

       

I tow a vehicle behind my motor home.  

Attendees:   One Person $30.00.00   Two Persons $30.00.00   Two plus Guest $0.00.00

I (We) are first time attendee(s).

Guest Name:   Enter guest first and last names or “None.”

     

Handicap Parking         30 Amps   50 Amps

Do you or your traveling companion use any of the following, cane, walker, electric wheel chair, scooter, C-PAP?  

If Yes, please indicate which one(s):

Special Diet Needs  

His:  

Hers:

  I will volunteer to help at the Muster

Tours

  Tour#1 Forever Everly - Cost: $30.00

March 25: Forever Everly is a tribute group to the Everly Brothers and includes lasagna soup and bread light dinner. Purchase your tickets when you make your space reservations at the RV Resort.   Total: $

  Tour#2 Hideout steakhouse and BBQ - Cost: $0.00

March 26 5pm group dinner. Everyone pays on your own, just let us know if you plan to go.   Total: $

  Tour#3 Burgers and dogs - Cost: $0.00

March 27th 5pm BBQ. Host chapters will provide the burgers and the hot dogs with buns. bring sides and condiments for the BBQ!   Total: $

Liability Release

In consideration for my (our) attendance, I (We) hereby release and agree to indemnify and hold harmless SMART, its officers, directors, employees, agents, successors, and assigns from any and all liabilities, claims, losses, and/or damages arising from my (our) attendance at this event.

All attendees must read and sign this form.

Name Signature Date
Pilot:
Copilot:
Guest:

Total Submitted: $_____________________

Please mail a copy of this form along with your check, (payable to AZ Roadrunners), to Erwin Greven, 1229 N Via Alamos, Green Valley, AZ 85614.