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2011 HDT National Rally

Kansas State Fairgrounds RV Park 2000 N. Poplar Street Hutchinson, Kansas 67502

Phone: 800-362-3247 or 620-669-3608

October 16-22, 2011

Steve & Gail Dixon 101 Dixon View Lane Unicoi, TN 37692

Larry Eberle 111 Maple Ave. Oakley, Kansas 67748

Phone: 785-672-4242 E-mail [email protected] E-mail: [email protected]

The National HDT Rally is a Social and Training Event for HDT Owners and Prospective HDT Owners. There will be Training Seminars to better Familiarize an Owner with his or her rig.

(Please Print)Name Spouse's Name Address Phone Forum Names First First City E-mail Address Last Last State Zip

Please indicate Number of Participants. Prices are per person Registration Fee per Person over age 17 required Hog Wild BBQ Dinner

BBQ Beef Pork Ribs Chicken

$50.00 x $12.50 x

_$ ___$ _

Brunch, October 22, 2011 Pizza Party Late Fee

(For registrations received after 9/10/11)

$9.00 x ____$ FREE x______________ 10.00____$_________ $ Total $ 132.00

Park Fees: $132.00 for the week of Oct. 16-20, 2011

This includes full hookups/ 50amp or 30 amps for 6 nights.

IF YOU WISH TO ARRIVE EARLY OR DEPART LATE

You must make direct payment to the Kansas State Fairgrounds who have a payment box in the campground. It is not necessary to make advance reservations. Phone: 800-362-3247 The regular rate is $20.00 per night. Please send your check for the total due with the completed registration form.

Make checks payable to: Gail Dixon. Put HDT Rally on the memo line. MAIL TO: Gail Dixon, 101 Dixon View Lane, Unicoi, TN 37692 Page 1

Rally Registration Deadline: Check and Registration forms must be received by September 10, 2011 HDT Rally Refund Policy: The Rally Organizer shall upon request, refund all monies to the individual requesting same, providing the monies have not already been disbursed and are not refundable to the Rally Organizers. If this is not acceptable, the individual shall contact the HDT Rally Committee. The Rally Organizer and the Rally Committee shall decide jointly to grant or deny said request. Their decision shall be final. There will an additional fee of $10.00 for all registrations received after September 10, 2011

Signatures are required from all persons attending the 2011 HDT National Rally

I/We agree that we shall not hold The Kansas State Fairgrounds or any organizer of the 2010 HDT Rally responsible for any personal injury of any kind and includes, without limiting it, whether injury is caused by a condition of the premises, another rally attendee, or any other person. I/We recognize that in signing this paper, we are waiving a legal right to recover damages.

Signature: Signature: Signature: Signature:

Date: Date: Date: Date:

You will receive one free t-shirt for each person on your registration but we will need your sizes. We need this information by September 10, 2011 to give us time to have t-shirts made in time for the rally. If you don't have the registration in by then you will not receive a tshirt. We may have some for purchase but don't count on it. Male Female XXXL___ XXXL___ XXL___ XXL___ XL___ XL___ L___ L___ M___ M___ S___ S___

You may buy extras t-shirts for $12.00 ea. Just enter number of shirts in the sizes below. Male Female XXXL___ XXXL___ XXL___ XXL___ XL___ XL___ L___ L___ M___ M___ S___ S___

Number of additional shirts @ $12.00 ea. ______ x $12.00

Total___________

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