Online Registration Form

Registering for the MD Samboree is easy using this online registration form.
1. Fill in the blanks                           3. Click on Submit Application        
2. Print the completed form           4. Mail payment and printed form    

Mail this page, with your check made payable to MD GOOD SAM, to: 
Kim Durham    4219 Greys Run Circle   Belcamp, MD 21017. 
Cut off date for PRE-Registration is May 10, 2007
Late charges will be assessed on all forms postmarked after May 10, 2007

SPACE STILL
AVAILABLE

Spring Samboree
A Weekend of Races
May Fri. 25th thru Sun. 28th
(Early Bird Thurs. May 24th)

DIRECTIONS: Just follow I-70 to exit 56 and take Patrick Street to the Frederick Fairgrounds.
Good Sam #
Required


Name:
Address:
City:

State:

 Zip
Phone:
E-Mail:

Parking Choice
Required

(Parking requests for PRE-Registrants ONLY)
Those arriving after 7pm will be parked at the discretion of the Wagon Master. 
Late / Unregistered guests will be parked HOBO style.
No rigs will be parked during Opening Ceremonies (You'll be parked afterwards.)

 Chapter Area 
State Area
Generator Area
Handicap Walking Area (Close to the Buildings w/regular hookups)
Full Handicap Parking Area? (30AMPS Handicap Tag or Mirror Tag IS Required)
Type of Unit
Required		 Motor Home
Travel Trailer
5th Wheel
Other
Length of Unit

Adults   Teens 13-17 Juniors 6-12 Children 2-5

Samboree Fees (based on # of adults):
$80 (2 adults & up to 2 children under 18);  $90 Late Registration
$75 (1 adult & up to 2 children under 18); $85 Late Registration
$25 EACH Extra Adult (#)
$15 EACH Extra Teen (13-17) (#)
$ 8 EACH Extra Child (under 13) (#)
$22 Early Bird Parking (begins 10am Thursday, May 24)
$6 Each Arts & Craft/Flea Market Table (#) Electricity Needed?
 (NO 50/50 Raffles at the Flea Market / Arts & Crafts Event)
Tour "Hobby Town", Thurs 1:30-4pm @ Free  (#)
Tour "Glade Valley Horse Farm", Fri 1-4pm @ Free (#)
Tour "Winery", Fri 1-4 @ Free  (#)
$12 Add'l fee for non-Good Sam Members
 $ TOTAL ENCLOSED (Your Canceled check will be serve as your receipt and confirmation)

PLEASE SIGN:

I, the undersigned, accept full responsibility for our unit and persons in our unit while attending the Maryland Good Sam Samboree, and hold blameless the Maryland Good Sam Organization for any claims for personal injury or damage to my unit.

Signature _______________________                  Is this your first Samboree?         Yes   No  
Date                                          Is this your first MD Samboree?  Yes   No

If you would like to help with any of the jobs at the Samboree please check all that apply below.  Thank you!!

Parking
Electric  

 Hospitality
Security    		 Clean-up
Other 

Thank you for using our online registration. Your cancelled check will be your confirmation. For a written confirmation, send a SASE (Self Addressed Stamped Envelope). Request for refund must be in writing and mailed to the State Director within 10 days of the Samboree. A $10 processing fee will be assessed. Please print this completed page now before pressing the Submit Application button below.  Mail this SIGNED WEB page, with your check made payable to MD GOOD SAM, to: 

Kim Durham
4219 Greys Run Circle
Belcamp, MD 21017

This form must be mailed and postmarked by May 10, 2007.