Saskatchewan Provincial Good Sam Samboree     

Prince Albert, Saskatchewan.

Have a Historical Hysterical Time in Prince Albert

June 8 – 12, 2011

Notations:       1. If groups wish to park together, they must arrive together. No exceptions.

                        2. Gates will not be open until 8:00am Wednesday.

                        3. Register before January 31, 2011 for a chance to win a free registration.

                        4. Registration must be paid in full at time of application.

                        5. Refunds after May 15, 2011 will be provided for medical reason.

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2011 Registration

Pilot ________________________________   Co-Pilot ________________________________________

                (Last Name)            (First Name)                  (Last Name)                     (First Name)

Address ______________________________  City ___________________________ Prov./State _____

Postal/Zip ______________ Telephone ___________________________ E-mail ____________________

Good Sam Chapter ______________________________ Good Sam Membership #____________________

First Time Samboree?   Yes ___ No ___ How Many Samborees have you attended? ___________________

Extra Guests Names ________________________________________________________

Special Needs: ___________________    Electrical required   Yes ____   No_____

                                                            Mobility only     ___

Registration must be paid in full at time of application

Registration Fees- Power Extra                                                       Mailing Instructions:

RV with 2 adults     $109.00                ____________                        Registrar

RV with 1 adult       $ 84.00                 ____________                        Kathy Henfrey

Additional adult     $ 25.00                 ____________                        1427 Benjamin Crescent

Electric only          $ 40.00                  ____________                       Regina, SK   S4X 4L3

Full Service           $ 70.00                 ____________                        Phone 306 543-9801

 (60 sites available)                                                                                                         E-mail:

(Banquet & Pancake Breakfast included in above rates)                                                                          kathyhenfrey@sasktel.net

TOTAL                                 ____________                         

Make Cheques Payable to:

Saskatchewan Samboree 2011