Please note that all fields followed by an asterisk must be filled in.
First Name*
First Name*
Last Name*
Last Name*
E-mail Address*
E-mail Address*
Web Site URL
Street Address*
Street Address*
City*
City*
State/Prov*
State/Prov*
Zip/Postal Code*
Zip/Postal Code*
Country*
Country*
Country
United States
Canada
----------------
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribadi
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Former Republic of Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Federated States of Micronesia
Moldova
Monaco
Mongolia
Monserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
S. Georgia and S. Sandwich Isls.
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and The Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
St. Helena
St. Pierre and Miquelon
Sudan
Suriname
Svalbard and Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
US VIrgin Islands
Wallis and Futuna Islands
Western Sahara
Yemen
Yugoslavia (former)
Zaire
Zambia
Zimbabwe
Home Phone
Business Phone
Cell Phone
Nickname (Name to be used on badge)*
Nickname (Name to be used on badge)*
Age Range - Registrant 1
---Select--- \nUnder 30
30 - 40
40 - 50
50 - 60
60 - 70
Over 70
RV-Dreams Forum User Name
Name - Registrant 2 (Enter "None" if single registrant)*
Name - Registrant 2 (Enter "None" if single registrant)*
Last Name- Registrant 2 (if different)
Nickname - Registrant 2 (Name to be used on badge; Enter "None" if single registrant)*
Nickname - Registrant 2 (Name to be used on badge; Enter "None" if single registrant)*
Age Range - Registrant 2
---Select--- \nUnder 30
30 - 40
40 - 50
50 - 60
60 - 70
Over 70
Additional Persons - Enter Names & Ages or "None"*
Additional Persons - Enter Names & Ages or "None"*
Additional Persons Participation*
Additional Persons Participation*
---Select--- \nFull Rally - $100
Accomodations & Meals - $85
Accomodations Only - $15
No Additional Persons
Accomodation Selection*
Accomodation Selection*
---Select--- \nRV Site
Camper Cabin
Rhinestone Cowboy Cabin - ALREADY TAKEN!!
The Comets Cabin - ALREADY TAKEN!!
Braschler Family Cabin
Rental Fifth Wheel - ALREADY TAKEN!!
Savannah House Hotel Room
None - Commuting To Rally
RV Type*
RV Type*
---Select--- \nMotorhome - Class A
Motorhome - Class B
Motorhome - Class C
Fifth Wheel
Travel Trailer
Other (Truck Camper, Pop-up, etc)
None
RV Length (No Rig Too Big!)*
RV Length (No Rig Too Big!)*
---Select--- \nOver 40 feet
35 - 40 feet
30 - 35 feet
Under 30 feet
Not Applicable
If Motorhome, Will You Be Towing Another Vehicle?*
If Motorhome, Will You Be Towing Another Vehicle?*
---Select--- \nYes
No
Not Applicable
If you want to be parked next to another attendee, list names
Arrival Date (Just to give us an idea - we won't hold you to it)*
Arrival Date (Just to give us an idea - we won't hold you to it)*
---Select--- \nJune 1
June 2
June 3
June 4
June 5
June 6
June 7
June 8
June 9
June 10
June 11
June 12
Departure Date (Again, we won't hold you to it)*
Departure Date (Again, we won't hold you to it)*
---Select--- \nJune 14
June 15
June 16
June 17
June 18
June 19
June 20
June 21
June 22
June 23
June 24
June 25
June 26
June 27
June 28
June 29
June 30
Special Celebrations, Anniversaries, Birthdays, etc.
Special Needs? (Accessibility, Dietary, etc.)
RVing Status*
RVing Status*
---Select--- \nCurrent Full-timer
Future Full-timer - With Rig
Future Full-timer - No Rig Yet
Current RVer - No Plans To Full-time
Still Researching Possibilities
None Of The Above
If Current Full-timer, Year Started
If Future Full-timer, Year Planning To Start
RVing Experience
---Select--- \nNone
Less than 2 years
2 - 5 years
5 - 10 years
10 - 20 years
20 - 30 years
Over 30 years
Bringing Pets?*
Bringing Pets?*
---Select--- \nYes
No
If Bringing Pets, Enter Name & Type
Would you consider being a volunteer at the Rally?
---Select--- \nI'd be happy to
We'd both be happy to
Nah, you silly people planned it, now handle it :)
List any special talents or knowledge you might share with the group
List any product or service you would like to promote at the Rally
List any doorprizes you are willing to donate or that you have conned someone else into donating :) (Keep full-timer space considerations in mind)
Payment With Registration*
Payment With Registration*
---Select--- \nDeposit - RV Site - $25.00
Deposit - Camper Cabin - $34.00
Deposit - Rhinestone Cowboy Cabin - $59.50
Deposit - The Comets Cabin - $80.75
Deposit - Braschler Family Cabin - $89.25
Deposit - Rental Fifth Wheel - $72.25
Deposit - Savannah House Hotel - $66.00
Deposit - Commuter - $25.00
Full Payment - RV Site (Couple) - $275.00
Full Payment - RV Site (Single) - $200.00
Full Payment - Camper Cabin - $315.00
Full Payment - Rhinestone Cowboy Cabin - $415.00
Full Payment - The Comets Cabin - $595.00
Full Payment - Braschler Cabin - $635.00
Full Payment - Rental Fifth Wheel - $480.00
Full Payment - Savannah House Hotel - $435.00
Full Payment - Commuter (Couple) - $175.00
Full Payment - Commuter (Single) - $100.00
Would You Like A Rally T-Shirt? ($15 Each, but we are working on sponsors to cover the costs - no promises)*
Would You Like A Rally T-Shirt? ($15 Each, but we are working on sponsors to cover the costs - no promises)*
---Select--- \nYes, no matter what
Yes, if you get enough sponsors
No thanks
T-Shirt Quantity*
T-Shirt Quantity*
T-Shirt Size - Enter Sizes To Match Quantity (S,M,L,XL,XXL,XXXL)*
T-Shirt Size - Enter Sizes To Match Quantity (S,M,L,XL,XXL,XXXL)*
Amount Added To Registration For T-Shirts*
Amount Added To Registration For T-Shirts*
Payment Method (Please add 3% processing fee if using PayPal)*
Payment Method (Please add 3% processing fee if using PayPal)*
Date Check Mailed Or Payment Submitted Online*
Date Check Mailed Or Payment Submitted Online*
Comments