2024 AZ Tumbleweeds Annual Holiday Luncheon Registration Form

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Start Date: 2024-12-09       Departure Date: 2024-12-09

The Links Neighborhood Grill

  • Address: 18823 Country Club Pkwy, Peoria, AZ 0
  • Phone: (623) 561-1681
  • For Reservations Contact: Campground

Sponsor(s): AZ Tumbleweeds

Host: Rich Caruso     Phone: (714) 222-8867     Email: havasulakeview@yahoo.com


Muster Costs:

Single Cost: $0.00   Couple Cost: $0.00   Couple + Guest Cost: $0.00  

Registration

An entry in all fields shown in the registration form is required.

Pilot:   SMART#:

Copilot:   SMART#:

   

Pilot's Email:

       

In Case of Emergency (ICE) Contact Information

Please provide at least one emergency contact other than your Copilot.

   

   

RV Information

       

       

I tow a vehicle behind my motor home.  

Attendees:   One Person $0.00.00   Two Persons $0.00.00   Two plus Guest $0.00.00

I (We) are first time attendee(s).

Guest Name:   Enter guest first and last names or “None.”

     

Handicap Parking         30 Amps   50 Amps

Do you or your traveling companion use any of the following, cane, walker, electric wheel chair, scooter, C-PAP?  

If Yes, please indicate which one(s):

Special Diet Needs  

His:  

Hers:

  I will volunteer to help at the Muster

Tours

  Tour#1 Holiday Luncheon at The Links Neighborho - Cost: $0.00

We will meet at the Links Neighborhood Grill at 11:00 am.   Total: $

Liability Release

In consideration for my (our) attendance, I (We) hereby release and agree to indemnify and hold harmless SMART, its officers, directors, employees, agents, successors, and assigns from any and all liabilities, claims, losses, and/or damages arising from my (our) attendance at this event.

All attendees must read and sign this form.

Name Signature Date
Pilot:
Copilot:
Guest:

This event does not have a muster fee. Please mail a copy of this form to Rich Caruso, Po Box 26382, Prescott Valley, AZ 86312.