2010 Rally Registration

	Level IV Program Info
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Chris & Pam DePriest
Arkansas District Directors
Contact Us

S.I.G. Programs

S.I.G.'s (Special Interest Groups) are for the special interests of the membership. Click the patches above to visit the GWRRA SIG's web page, there may be a special interest group for you!

CURRENT MOON

moon info

Arkansas 2010 District Rally

May 27 - 29, 2010

Embassy Suites Northwest Arkansas

Rogers, AR

Once you fill out the following form and click on "SUBMIT", you will be directed to Pay-Pay for payment. Use your credit card or money in your Pay-Pal account to pay for registration. Once you make payment, your registration is complete. You will be sent an e-mail receipt if you include your e-mail address in the form.

Deadline for Pre-Registration: April 15, 2010

REGISTRATION FORM

Full Registration

How Many?

Pre-
Register

On-Site
Register

GWRRA Member

$25.00 each

$30.00 each

Life Member

$15.00 each

$20.00 each

Non-Member

$30.00 each

$35.00 each

13 - 17 Years Old

$5.00 each

$10.00 each

50/25/25 Tickets *

* Saturday Night Drawing—Must Be Present To Win

Grand Prize Tickets **

Tickets @

$1.00 each

** Must Be Present To Win

Full Registration Required For Level IV Breakfast

Children age 12 and under are admited FREE!
(Must Be Registered to Compete for Prizes.)

Level IV Breakfast (Current)

Master Tour Number

Pre-
Register

Master Tour Rider ( Enter # to Register )

Level IV #

Free

Master Tour Co-Rider ( Enter # to Register )

Level IV #

Free

Level IV Breakfast (Not-Current)

Master Tour Number

Pre-
Register

Master Tour Rider ( Enter # to Register )

Level IV #

$5.00 each

Master Tour Co-Rider ( Enter # to Register )

Level IV #

$5.00 each

Grand Total

Rider GWRRA# Age Co-Rider GWRRA# Age Address City State Zip Telephone E-Mail Region District Chapter Direct Miles to this Rally

Hotel Information Requested by the Convention & Visitors Bureau

Please press the Submit button ONLY ONCE.
The server needs to process your request and send emails.
This will take just a little while. Please be patient.

Thank you for letting us know you're coming!
Remember, your registration is not final until you've made payment.

I/We agree to hold harmless GWRRA, any co-sponsoring organizations and any property owners for any loss or injury to self or property by reason of participating in this rally.