2012 Region 6 Rally

September 5-9, 2012

Wayne County Fairgrounds & Expo

861 Salisbury Rd.

Richmond, IN  47374

Rally Fee:

     2 People in RV              $ 300.00           

     1 Person in RV              $ 223.00             

     Guest                            $   82.00           

 Rally Fee Includes:

     4 Nights camping with 30 Amp & Water 

     2 Dinners; 1 lunch

     1 Potluck with meat provided

     1 Community Breakfast (potluck)

     1 Continental breakfast

     Travel the Whitewater Valley Railroad to Metamora Village, lunch at The Cat & Fiddle;

          optional carriage ride, horse-pulled canal ride, village tour

     Tiffany Stained Glass Windows Trail

Optional Activities:

         Chocolate Trail Tour                    Overbeck Pottery Museum          Garr House Farm & Museum

         J & J Winery                               Gennett Mansion                         Indiana Antique Alley Loop Trails

         Levi Coffin House                        Antique Alley Trails                    Madonna of the Trail

         Model T Ford Museum                 Mural Trail                                 Warm Glow Candle Outlet             

Limited to 50 units (by postmark)

 Reservation deadline: Aug. 5

Please send signed registration/disclaimer form and check payable to:

Wanda Llewellyn

6959 LeMaster Rd.

Athens, OH 45701

For further information please call (740) 707-2063

or e-mail wanda_ron67@yahoo.com

(include underscore between wanda and ron)

                  PLEASE NOTE: When you print this information, it should appear on two separate pages

                  and fit within the standard document format.

                        2012 REGION 6 RALLY REGISTRATION AND DISCLAIMER

Name: __________________________________________________________________ Klub No: _____________

                            His                            Hers                                          Last

Address: _______________________________________________________________________ First Rally?     _

City: ______________________________________________ State: _________________ Zip Code: __________

Phone: ___________________ Cell: ____________________ E-mail:____________________________________

Guest(s) ____________________________________________________________________________________

Handicapped?   #______                                  Diabetic? #______

Total Enclosed: _______________ (do not include optionals)

                        The published Regional Rally Cancellation Policy Applies!

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 indemnity as part of my application.

       All adult members and their guests must sign and in so doing, assume all responsibility for minors in their care.

Signature: ____________________________________________  Signature: ____________________________________________

Signature: ____________________________________________   Signature: ____________________________________________