Text Box: 200 OHIO STATE RALLY SCIOTO COUNTY FAIRGROUNDS LUCASVILLE, OHIO JUNE 22-25, 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, or STATE Office held _______________________________ ____________________________________________________________ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * REGISTRATION FEES: $85.00 Per Family Unit $_______________ $90.00 Per Family Unit after 5-24-05 $_______________ $75.00 Per Adult - 1 person $_______________ $80.00 Per Adult - 1 person after 5-24-05 $_______________ $35.00 Each Additional Adult (18 years +) $_______________ $15.00 Each Adult Walk-in with no camping $_______________ $12.00 Each Saturday catered meal _____ X 12 = $_______________ $ 6.00 Each Child Sat. catered meal _____ X 6.00 = $_______________ $12.00 Night Extra Camping _____ X 12 = $_______________ TOTAL ENCLOSED $_______________ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * I/We plan to attend the 2005 Ohio State Rally and have enclosed the proper fees. I/we hereby release NCT, Inc., Ohio State NCT and the Scioto County Fairgrounds of any responsibility. Signed: _________________________________ NCT #___________ 2006 OHIO STATE RALLY SCIOTO COUNTY FAIRGROUNDS LUCASVILLE, OHIO JUNE 22-25, 2005 REGISTRATION: Thursday, June 22, 2006 - 1:00-2:00 p.m. Friday, June 23, 2006 - 8:00-10:00 a.m. Make checks payable to: 2006 Ohio State Rally Mail check with registration form to: Mrs. Virginia Gharky 10376 Brosius Rd, Lot 3 Garrettsville, OH 44231-9411 Phone: (330) 527-5286 Email: Gharky@msn.com 3 Nights Camping Youth Activities Friday Morning Breakfast Arts & Crafts Friday Night Dinner Bingo Saturday AM Pancake Breakfast Popcorn Sunday Morning Hospitality Games Door Prizes Ice Cream Social 2 Chevrons Flea Market Register early to park together. Early arrivals on June 21, 2006. Emergency phone numbers: Scioto County Sheriff - 740-354-7566 Ohio Highway Patrol - 740-354-2888 DIRECTIONS: Take U.S. 23 to Lucasville, Ohio. Turn on State Route 728. Go under the railroad, then turn on Fairground Road. WATCH FOR NCT SIGNS. COME WITH EMPTY HOLDING TANKS! Come Join the Fun