KENNEBEC RIVER ROVERS CAMPING CLUB
MEMBERSHIP APPLICATION-2010
Date of Application_______________________________________________________________________
Good Sam Number_______________________________Valid thru_________________________________
Name: Mr. _____________________________________Date of Birth______________________________
Mrs. _____________________________________Date of Birth______________________________
Anniversary Date___________________________________________________________________
Children 1______________ 2 ______________ 3 ______________ 4 ______________ 5 ______________
Mailing Address_____________________________________Telephone No.________________________
______________________________________ Cell Phone No,________________________
E-mail address______________________________________________________________
TYPE OF CAMPER
Pop-Up_____ Truck Camper_____Tag Along_____ 5th Wheel_____ Motor Home (A)____ (B)____ (C)____
Size of Camper__________________________________________________________________________
Type of Car or Truck___________________________ License No._______________ State____________
Reason for joining the Kennebec River Rovers_________________________________________________
_____________________________________________________________________________
Number of days you plan to camp with us per year?______________________________________________
Number of winter meetings you plan to attend?__________________________________________________
How did you learn about this chapter?________________________________________________________
______________________________________________________________________________
Sponsor/s_______________________________________________________________________________
Comments:______________________________________________________________________________
______________________________________________________________________________