Text Box: ALABAMA STATE /DISTRICT FOUR RALLY Houston County Farm Center Dothan, Alabama March 30 - April 2, 2006 Name _______________________________________ NCT # _________ Spouse’s Name _______________________________________________ Address _____________________________________________________ City _____________________________ State ________ Zip __________ Phone ___________________ Emergency _________________________ No. Adults _________ No. Children _____________ Ages ____________ Arrival Date _________________ Departure Date ___________________ Type & Size of Unit __________________________________________ Special Needs (Explain) ________________________________________ Chapter Name & No. __________________________________________ NAT, DIST, STATE Office Held ________________________________ ____________________________________________________________ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * REGISTRATION FEES: $100.00 PER UNIT (2 ADULTS) Prior to 3-21-06 $______________ $75.00 Per Unit (1 Adults) After 3-21-06 $______________ $25.00 Each additional person over 18 yrs. $_____________ $5.00 Charge for late Registration $_____________ TOTAL ENCLOSED $______________ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * I/We plan to attend the Alabama State/district Rally and have enclosed fees as required. I/We hereby release NCT, Inc., Alabama State NCT and the Houston County Farm Center of any responsibility at this Rally. Signed: __________________________________ NCT #____________ ALABAMA STATE /DISTRICT FOUR RALLY Houston County Farm Center Dothan, Alabama March 30 - April 2, 2006 REGISTRATION NOTES Makes checks payable Tin U.S. Funds to Alabama State NCT Rally Mail to: Linda Fuhrman 1983 Highway 77 Southside, AL 35907 Fees include: 3 Nights parking (water & electric) 2 Chevrons, Breakfast, Dinner, Entertainment Scheduled Events: Bingo, Art & Crafts, Games, Flea Market All American Alabama Chili Supper - Thursday Night, March 30th. 6. Directions: Located on Ross-Clark Circle SE, Entrance on Alabama Hwy 53 South (Cottonwood Road) Emergency Phone 334-792-5730 We Hope to see you There !!