SOUTHEAST AREA FMCA PRESENTS  SEA SALUTES THE MILITARY   FEBRUARY 6-10 2013
FMCA Number	If you do not have an FMCA number you can go to www.fmca.com to apply for one.
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 1/20/13 WILL BE HELD AT WILL CALL
GUEST INFORMATION: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:
I Plan on Attending the Ladies Breakfast?  How many to attend?	PLEASE SELECT THE DOLLAR AMOUNT BELOW TO RECEIVE TICKET(S)
PLEASE SELECT ONE FROM THE BELOW LIST PARKING TYPE:(G) General Parking or (H) Handicap Parking - Generator 7AM - 11PM Only Handicap Parking - Reserved for those with qualifying medical needs - Limited space First Come-First Serve (NON) No Generator Area -  No Generators allowed (FULL) Full Generator Area - Can Run generators 24 Hours a day if needed (GPE) General Parking or (HCE) 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 (P) Passport Parking - Off Grounds Motorhome Parking - Can Attend Exhibits, seminars and entertainment only (G) General Parking (H) Handicap Parking (NON) No Generator (FULL) Full Generator (GPE) General Parking with electric (HCE) Handicap Electric Parking (P) Passport Parking 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 AFTER JANUARY 20TH, 2013 YOU WILL NEED TO CALL THE OFFICE AT 352-796-0154 TO REGISTER
	Pre Register
2 Person Coach	Please select 1 G, H, NON, FULL GPE, HCE P Passport
1 Person Coach	Please select 1 G, H, NON, Full GPE, HCE P
Ladies Breakfast	Please select 1 Ladies Breakfast 2 Ladies Breakfast 3 Ladies Breakfast 4 Ladies Breakfast
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
Non-FMCA Member	Please select 1 Non-FMCA Member
Date	5/19/2013
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 2/1/13 and your credentials must be postmarked no latter then 2/5/13. 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.