The First Ever   Four Corners Unit Rally   Be a part of History!

February 16^th , 17^th & 18^th, 2007

  Dead Horse Ranch State Park, Cottonwood, Arizona

RESERVATION FORM

Name: ___________________________ Spouse: _________________________

Children: _________________________________________________________

Phone:(____)______________________ E-mail: __________________________

Address: _________________________________________________________

City: ____________________________State: _________ Zip: ______________

Model of Trailer: ________________ Year: _______ Tow Vehicle: ____________

Outing Fee is $30 which includes 2 nights camping

Pot Luck dinner Saturday night (Bring whatever you like)

Campfires every night (Bring a good story or two)

Children & Pets are more then welcome

Make checks payable to: Richard Girard

Mail to: Richard Girard 18223 N 1^st Drive, Phoenix, AZ 85023

rgirard5@cox.net  ***  (602) 510-1686 (cell)  ***  azflycaster (airstreamforums.com)

Liability: In consideration of the acceptance of the right to participate; entrants, participants, and spectators, by execution of this registrations form, release and discharge the Four Corners Unit and their officers from any and all known or unknown damages, injuries, or losses, judgments, and/or claims from any cause whatsoever that may be suffered by any participant to his/her person or property, Further, each participant expressly agrees to indemnify all conduct of any participant(s) or spectator(s).

Signature: __________________________________ Date: _____/______/________

This is a Dry Camping Group Site