Samboree Registration Form
KAMPERS HO DOWN
____________________________________________________________________________________________
2010 ILLINOIS GOOD SAM SAMBOREE
LABOR DAY WEEKEND, Friday, SEPTEMBER 03 TO Monday, SEPTEMBER 06
MARSHALL/PUTNAM COUNTY FAIRGROUNDS 913 UNIVERSITY AVE HENRY IL 61537
Activities: Entertainment; craft/flea market; hospitality; Samgo; 2-free breakfast- vendors; seminars; games for
adults; pre-teen and teen activities, food stand on grounds; fun; laughs; good eats; pop corn; Ice Cream Social;
much more !!!
Parking will be Hobo style. For Illinois members: Each chapter is requested to donate a minimum of two $10
door prizes and a $10 item for the Teens Blue Light special. Each rig is asked to bring 2 dozen cookies and
each chapter to donate fresh fruit for hospitality. Any questions contact Jim and Judie Frcka, State Director,
847-644-2709 rrack2rv@yahoo.com or the treasurer at ilgstreas@yahoo.com No cut off date for Samboree registration. However, catered meal must be paid by August 20. Registration refund with notice sent to State Treasurer within 10 days
of Samboree, a $5.00 fee will be charged for cancellation. Exceptions must be approved by the State Director.
All refunds mailed after the Samboree. illinoisgoodsam.org
PLEASE COMPLETE ALL INFORMATION
Name(s)_______________________________________________________ (______________)
(include all names)
(office use only)
(office use only)Address_______________________________________City_______________________
State_________Zip____________Phone(_______)_______________________________
Email____________________________________________________________________
Chapter Name______________________________ Like to join a Chapter?____________
Is this your first Samboree?___________ First Illinois Samboree?____________
Registration fees, PLEASE read carefully: No early arrivals before September 01.
Unit with 2 adults $70.00 for the weekend including electric_____________
Unit with 1 adult $65.00 for the weekend including electric_____________
Unit with 2 adults $45.00 for the weekend – generator only____________
Unit with 1 adult $40.00 for the weekend – generator only ___________
►Children under 18 are free, with you in your unit
Add $15.00 for each additional person over 18 years No. _____ equals ________
No early arrival before Wednesday, September 01, 2010.
Early arrival $17.00 each day Wednesday, 09/01____Thursday, 09/02______ equals________
A $5.00 charge for registering at the Samboree. Late stays will pay the fairgrounds directly.
#Adults_________#Teens_________#9-12________#5-8________#4/under_______
Do you need handicap parking?________Must have a valid state approved sign or license plate.
(Exceptions must have prior approval by the Illinois Good Sam State Director or Treasurer.)
DO NOT REQUEST HANDICAP PARKING, UNLESS YOU ABSOLUTELY NEED IT.
Catered meal by American Legion: Kampers Kountry Stew, green beans, salad, rolls, dessert.
Saturday Catered Meal $10.50 per person No. of Meals________ equals__________
equals__________Checks payable to Illinois Good Sam Please send payment with registration. Thank You!! Total:______
Send registration form/fees to: Don Husser, 205 W. First St., Box 217, Malden, IL 61337-0217, phone 815-866-2452 ilgstreas@yahoo.com Confirmation cards for reservations received after August 20, will be held at parking.
Sorry we do not accept credit or debit cards. Cash or check only.
We (I) understand the Illinois Good Sam State Committee has taken reasonable and necessary safety
precautions against accidents or illness which may occur during the Samboree. Therefore, WE (I) accept
FULL RESPONSIBILITY for the welfare of our unit and all persons in our unit while attending the Illinois Good
Sam Samboree. We also understand that Fairground Rules Prohibit the consumption of Alcoholic beverages
anywhere, other than in our Own Travel Unit.
Signature_______________________________________________Date_____________
REGISTRATION NOT VALID WITHOUT SIGNATURE(official form)The Good Sam Recreational Vehicle Association of Illinois Reserves the Right to Refuse Admission to Anyone Wishing to attend this Function.
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Click on paint brush to download registration form..
