Text Box: 21st ANNUAL KENTUCKY FRIENDSHIP RALLY WALNUT MEADOW RV PARK BEREA, KENTUCKY APRIL 22-23, 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: $95.00 Per Family $______________ $100.00 Per Family AFTER April 18th $______________ $15.00 (Each Adult over 2 per rig) $______________ (Children under 12, No charge) Catered Dinner Saturday Evening $8.50 Per Person No. _______ $_______________ TOTAL ENCLOSED $______________ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * I/We plan to attend the Kentucky Friendship Rally and have enclosed the required fees. I/We hereby release NCT, Inc., and Derby City Travelers Chapter #109 of any responsibility at this Rally. Signed: __________________________________ NCT #____________ 21st ANNUAL KENTUCKY FRIENDSHIP RALLY WALNUT MEADOW RV PARK BEREA, KENTUCKY APRIL 22-23, 2006 Make checks payable to: Derby City Travelers Mail to: Sue C. Washburn 6340 Bloomfield Road Bloomfield, KY 40008 Telephone: (502) 477-8953 Sites have water and electric. Dump Station & Propane available at the Campground. Special needs parking available. 4. Registration fee includes: Thursday & Friday Evening Meals Saturday Morning Breakfast Catered Dinner—Saturday Evening 3 Nights Camping, Two Chevrons Blind Auction, Door Prizes & Games Sunday Morning Hospitality GOLF - -Thursday - - Weather Permitting Walnut Meadow RV Park, Berea KY Exit #76 (State HWY 210) 1-2 miles West of I-75. Campground is on the Left Extra nights camping fee, (early and/or late) $18.00. Pay at registration. DO NOT PAY CAMPGROUND. Refunds will be made in the event of illness or death and written request received by April 18, 2006. Come and Join Us !