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NORTHWEST REGIONAL RALLY REGISTRATION FORM

May 17-20, 2011 - Grant County Fairgrounds - Moses Lake, WA


 After May 1 fees increase $30 per unit

Name:_________________________________________ Spouse Companion

Address:_______________________________________ Home Phone:

City, State, Zip__________________________________ Cell Phone:

WIT#___________________ Local Club/Chapter Involved in:

E-mail Address:_____________________________________ Home State

Check if Handicapped Parking is needed ____ Motor Home: Year_____ Length______ #Slides_____

Check if this will be the first NWRR you have attended _____

It’s a party Amigos Arrival Day  Water & Electric  Full Hookup  

Tuesday (May 15)  ____$165.00  ____$190.00  

Wednesday (May 16)  ____$145.00  ____$165.00  

Thurs/Fri/Sat

(May 17, 18,19,)  ____$125.00  ____$140.00  

Deduct for Single  ____($30.00)  ____($30.00)  

Add $35 each for  

____extra persons  $_____________  $_____________  

Add Late Fee after May 1  $ 30.00  $ 30.00  

TOTAL ENCLOSED  $_____________  $_____________  

(U.S. Funds)  

No time for a Siesta,

It’s time for a Fiesta Make Checks/Money Orders  

Payable to NWRR and Mail to:  

NWRR 2012  

% Joe Hesketh  

2503 158th Ave SE  

Bellevue, WA 98008-5417  


 Questions: Email NWRRtreasurer@aol.com                                          Office Use Only  

   Or call Joe 425-641-0278                                              #  Date Rec'd  Amount  DB  EM  ACK