SOUTHEAST AREA FMCA PRESENTS  SEA GOES HOLLYWOOD   FEBRUARY 1-5,2012
FMCA Number	If you do not have an FMCA number you can go to www.fmca.com to apply for one. You do not have to be a member of FMCA to attend this rally.
Primary Badge Name:Type your name as you want it to appear on your Badge
First:
Last:
Secondary Badge Name:      Type your name as you want it to appear on your Badge
First: :
Last :
Address where confirmation will be sent
Address1
Address2
City, State Zip
Phone Number
Email Address	Please enter a correct email address to receive your confirmation packet
Is this your first Southeast Area Rally?	YesNo
Coach Make
CHAPTER INFORMATION
Primary FMCA Chapter	YesNo
Chapter Name:	Chapter you will be caravan with.  If large group, please call the office to schedule an arrival time at 352-796-0154
CONFIRMATION PACKET
Do you wish your confirmation materials to be held at Will Call?	YesNo PLEASE NOTE THAT ALL REGISTRATIONS RECEIVED AFTER 1/13/12 WILL BE HELD AT WILL CALL
GUEST INFORMATION: This space is for additional guest in your coach		Please include the name(s) and age(s) of the guest who will be joining you for this event. Do Not include yourself or co-pilot.
Guest 1
First Name
Last Name
Age
Guest 2
First Name
Last Name
Age
EVENT:
Day(s) for Daily Passport:
PARKING TYPE: PLEASE SELECT ONE FROM THE BELOW LIST -  General Parking or Handicap Parking- Generator 7AM - 11PM Only Handicap Parking - Reserved for those with qualifying medical needs - Limited space First Come-First Serve No Generator Area -  No Generators allowed Full Generator Area - Can Run generators 24 Hours a day if needed General Parking or Handicap Parking with 30 Amp Electric - Please note there is an additional $165.00 fee applied and you need to bring an extention cord in case it is needed Passport Parking - Off Grounds Motorhome Parking - Can Attend Exhibits, seminars and entertainment only THE ABOVE INCLUDE ACCESS TO ALL EXHIBITS, SEMINARS AND ENTERTAINMENT - DO NOT NEED TO SELECT DAILY OR 3 DAY PASSPORT Daily Passport or 3 Day Daily Passport - Can Attend Exhibits, and seminars.  No entertainment or Motorhome Parking. Please specify day(s) above. General Parking Handicap Parking No Generator Full Generator General Parking with electric Handicap Electric Parking Passport Parking 3 Day Daily Passport Daily Passport PLEASE NOTE THAT YOUR SELECTION ABOVE IS WHAT YOU WILL BE REGISTERED FOR.  THE DROP DOWN BELOW IS STRICTLY FOR THE DOLLAR AMOUNT THAT YOU WILL BE CHARGED.  WHEN YOU HIT THE SUBMIT BUTTON YOU CAN VERIFY YOUR PARKING CODE.
REGISTRATION TYPE -  PRICE IN U.S. FUNDS    Please select correct type from 2 Person, 1 Person and if you have any guest
	Pre Register		After 1/13/12
2 Person Coach	Please select 1 General Parking Handicap Parking 30 Amp Electric Handicap Electric Full Generator No Generator Parking (DRY) $129.00 Passport Parking		Please select 1 if after Jan 13 General Parking $144.00 Handicap Parking $144.00 30 Amp Electric $309.00 30 Amp Handicap Elec $309.00 No Generator $144.00 Full Generator $144.00 Passport $124.00
1 Person Coach	Please select 1 General Parking $109.00 Handicap Parking $109.00 30 Amp Electric $274.00. 30 Amp Handicap $274.00 No Generator Parking $109 Full Generator Parking $109 Passport $ 90.00		Please select 1 if after Jan 13 General Parking $124.00 Handicap Parking $124.00 30 Amp Electric $289.00 30 Amp Handicap Elec $289.00 No Generator $124.00 Full Generator $124.00 Passport $105.00
Guest's over 11 years old	Please select 1 Guest 1 $60.00 2 Guest $120.00 3 Guest $180.00 4 Guest $240.00		Please select 1 Guest 1 $75.00 2 Guest $150.00 3 Guest $225.00 4 Guest $300.00
Daily Passport or 3 Day Daily Passport	Please select 1 Daily Passport 1 Person $15 Daily Passport 2 People $30 3 Day Daily Passport 1 Person $40 3 Day Daily Passport 2 People $80                                                                                                    Please select 1 Daily Passport 1 Person $25 Daily Passport 2 People $50 3 Day Daily Passport 1 Person $60.00 3 Day Daily Passport 2 People $120                         **DO NOT SELECT THIS IF YOU HAVE ALREADY SELECTED 1 OR 2 PERSON ABOVE**
Date	2/5/2012
Total Due $
	Send written refund request with Rally Credentials to SEA FMCA - PO Box 15304 - Brooksville, Fl 34604 A $15.00 Processing fee is charged.  There are no refunds after 1/25/12 and your credentials must be postmarked no latter then 1/30/12. There will be absolutely no refunds after the rally begins. Rally Credentials are Non Transferable.  Confirmation Credentials Must be displayed on your motorhome to facilitate your entry into Rally Grounds.