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Kansas State Rally
RESERVATION FORM
NAME_____________________________________________________NKK# ______________________
ADDRESS_____________________________________________________________________________
CITY_____________________________________ STATE______________ ZIP______________________
PHONE: ________________________ E-MAIL: _________________________________________________
UNIT INFORMATION : MH ___ FW ___ TT ___ Length: ______ # of Slides: ___
PASSPORT AMERICA MEMBER NUMBER_____________________________________________________
DATE OF ARRIVAL____________________________(Pay early days at arrival)
GOLF TOURNAMENT (Thursday AM) YES__________________ NO________________________________
CRAFTS YES___________________________ NO_________________________
HANDICAPPED? YES________ NO___________ DIABETIC? YES________ NO_________________
Disclaimer: All persons attending a Klub rally must sign this disclaimer in order to participate.
I agree, in consideration for being able to participate in this Newmar Kountry Klub activity, to release and to indemnify and hold harmless Newmar Kountry Klub and Newmar Corporation, its directors, officers and employees, from all liability for injury or damages to my person or property or the property of persons who accompany me to this activity. With knowledge of the type of risk or harm, which might occur at such activity, I sign this release and indemnify as part of my application. All adult members and their guests must sign and in so doing, assume responsibility for minors in their care.
Cancellation Policy: I understand and agree to the Cancellation Policy for Rallies, Caravans and Special Events.
Signature:_____________________________________________
Signature:_____________________________________________
Signature:_____________________________________________
Signature:_____________________________________________
(Please print, sign and mail this Disclaimer, with your Rally Fee, to the Rally Host.)
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