Keeshond Club of America

National Specialty 2005

RV Registration

 

Name ___________________________________________________________________________

Address _________________________________________________________________________

City ___________________________________ State __________ Zip _________________

Phone __________________________

Cell Phone (or emergency contact number) ______________________________________

Motorhome

RV License # _______________________ State ___________

RV Length _____________ Width (including slideouts & awnings) _____________

Towed vehicle: _____ Yes _____ No

If yes, Vehicle Make & Model _________________________________________________

If yes, Towed vehicle License # ____________________________________

Trailer

RV License # _______________________ State ___________

RV Length _________ Width (including slideouts & awnings) _____________

Tow vehicle Make & Model _________________________________________________

License # ____________________________________

 

Charge is $25 per night

 

Arrival night ________________________________

# nights ____________________________

Total amount due ($25/night) ____________________

Please make checks payable to "Buckeye K.C. Specialty 2005"

Send reservation form and fees to:

John Malak

5602 Bacon Road

Petersburg, MI 49270