BOOKING FORM
Please print all sections

Membership No. / Chapter (If any)
Name
Name
Mailing Address
Email
Preferred phone contact number / Registration No.
Motorhome Type / Length / m / Number of slideouts
Towed vehicle / Yes / No / Trailers maybe in a separate area. Please enter with cars/trailers detached for ease of parking. Exceptions for medical/disability reasons only.
Restricted Mobility / Yes / No
Do you require power for medical purposes? / Yes / No / There is very limited power – only powered sites for essential needs such as medical equipment – current medical certificate should be attached.
Can we email your confirmation to you? You can then print it out and bring it with you to enter the grounds. / Yes – that’s fine – I can manage that! / No thanks –post to my address above.
Do you wish to be a volunteer? / Yes / No / Do you wish to have a trade site? / Yes / No
Are you bringing any pets? / Yes / No / If YES, how many?
  • Generators will be allowed ONLY between 8 am and 11 am and then again between 4 pm and 8 pm.
  • Standard dog rules of CMCA chapter weekends will apply – on leads, not at happy hour under awnings unless everyone in the group agrees, not in or at community food areas or in showers/toilets. Please pick up after your dog!

Arrival time will be on the morning of Thursday March 8.Your specific arrival time will be noted on your entry permit. Departure will be before 2 pm on Wednesday March 14. Clean up crew will depart on the next day.
Refunds for cancellations will only be made in line with CMCA precedents.
If you wish to be sited with your friends, please ensure bookings are sent in together.
For more information – go to our website –

Early bird registration finishes on December 31, 2017 – after that date an additional fee of $15 per person applies to the rates below. Cost is as set out below and includes a non-refundable administration fee of $45.00 per person.

Please fill in below to get your early bird registration.

Please tick / Unpowered site plus registration fee for 1 person / Cost is $105.00
Please tick / Unpowered site plus registration fee for 2 people / Cost is $170.00
Please tick / Power required if available / Cost is $ 30.00 / Total $
Cheque attached $...... / Direct deposit to Combined Victoria Rally bank account
Bendigo Bank BSB 633 108 – Account 1443 80904 $......

Signed……………………………………………………………………..Date……………………………………

Pleasepostyour Registration formtoour Booking Steward, Victorian State Rally-

Hazel Goatman,17AntaresAvenue,Lara3212

Office use only / Received / Cheque banked / Bank deposit checked
Comments if any
Confirmation / Emailed / Mailed / Volunteer Form / Received
Notes