Registration form
2014 Area 10 Mini Rally
Ollie Liner Center: Plainview Texas
October 23-25 2014
Area 10 or Good Sam Club are not responsible for accidents or injury.
For Fun, Games and Entertainment, this is the place to be
Please put Last Name followed by First Name
Pilots Name____________________ _______________________________
Navigator’s Name___________________________________________________
Address ___________________________________________________________
City, State, Zip______________________________________________________
Good Sam Member Yes ____________________No______________________
Phone ________________ Cell _______________Put N/A if no phone
Email optional______________________________________________________
Rig Type 5th ___________ Motor home ______________ Other______________
Generator Yes__________ No________ From 7 am to 10:00 pm
First time to Area 10 Mini Rally?________________________________________
In case of Emergency, contact Name ____________________Number___________
Number of Adults in Rig ______________________________________________
Mail to Jim Odom 3701 Kirchwood Dr Plainview Texas 79072 Phone 806 777 0776
Early parking starts Tuesday October 21st
62 spaces w/water electricity on first come basis $75.00 + $10.00 per day early parking
Plenty of room for dry camping with water available if needed $45.00
*** Registration form only, pay when you register at the Mini Rally