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Start Date: 2025-11-01 Departure Date: 2025-11-06
Orange Grove RV Park
Sponsor(s): Golden Gate and Golden Gate
Host: Vicki Utt Phone: (661) 203-1965 Email: dennisutt.du@gmail.com
Muster Costs:
Single Cost: $25.00 Couple Cost: $50.00 Couple + Guest Cost: $75.00 Camping/night: $55.00
An entry in all fields shown in the registration form is required.
Pilot: SMART#:
Copilot: SMART#:
Home: Pilot's Mobile: Copilot's Mobile:
Pilot's Email:
Street
City State Zip
Please provide at least one emergency contact other than your Copilot.
Notify: Phone: Relationship:
RV Type: Make:
Model: Length:
I tow a vehicle behind my motor home. Total length of tow and towing vehicles:
Attendees: One Person $25.00.00 Two Persons $50.00.00 Two plus Guest $75.00.00
I (We) are first time attendee(s).
Guest Name: Enter guest first and last names or “None.”
Planned Arrival: Planned Departure:
Camping Costs: $ 55.00/night
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
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.