2025 October Camping and Halloween Fun Registration Form

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Start Date: 2025-10-24       Departure Date: 2025-10-30

Lake Catherine State Park Hot Springs, AR

  • Address: 1200 Catherine Park Rd, Hot Springs, AR 71933
  • Phone: (501) 814-4176
  • For Reservations Contact: Campground

Sponsor(s): AR Hogs

Host: Lisa Duckworth     Phone: (501) 772-4991     Email: ducktwin@gmail.com


Muster Costs:

Single Cost: $10.00   Couple Cost: $20.00   Couple + Guest Cost: $20.00  

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 $10.00.00   Two Persons $20.00.00   Two plus Guest $20.00.00

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 October Fall & Halloween Camping Fun - Cost: $0.00

Call as soon as possible to ensure a spot! 1-501-844-4176 Try to reserve sites between 55-70. If not you can join us at our spot for the Halloween Part 10/25/25. We will provide 2 dinners.   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:

Total Submitted: $_____________________

Please mail a copy of this form along with your check, (payable to Lisa Duckworth), to Lisa Duckworth, 806 Porter Road, Lonoke, AR 72086.