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Penn Coachmen Chapter of FMCA

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Rally Registration Form

Roxbury Holiness Camp

September 21 - 23, 2018

                Name       Reservations by September 9, 2018
         FMCA No. 
 E-mail address               Pay your dues for 2019 at this rally.
Day you plan to arrive at Rally  

Rally registration fee - $50.00.  Balance of fees will be collected at the rally.

An additional $10.00 will be charged for rally if registration is postmarked after September 8, 2018.


Make Checks payable to Penn Coachmen, print this page and mail to:

                                        Karl Deardorff

                                        1611 Myrtle Ave.

                                        Camp Hill, PA 17011


Number of Catered Dinners  

Length of Unit  

Handicap Parking Needed           No      Yes

First Time at Penn Coachmen Rally      No      Yes


Names of any Guests