2022 ARKANSAS STATE RV RALLY REGISTRATION
"CELEBRATION 2020 & Mardi Gras 2022"
APRIL 14 - 17, 2022
FOUR STATES FAIRGROUNDS, 3700 E. 50TH STREET, TEXARKANA, AR 71854
You may fill out this form online, print, and mail in with your pre-registration fees.
ACTIVITIES: Hospitality - Arts & Crafts - Flea Market - Samgo Cash Prizes - Ice Cream - Games Competition - Commercial Vendors - Live Entertainment - Golf Scramble
FACILITIES: Limited Electric and Water - Dump Station - Honey Wagon - Showers
LIMITED FULL HOOKUPS - ARRIVE WITH EMPTY HOLDING TANKS
PARKING: Early Bird Parking Monday, April 11 - $19.00 per night, payable when registering. Come together, park together. You will be parked by the State Wagon Master
and his Staff beginning Sunday at 1:00 PM or earlier if possible. Prior to Sunday a Holding Area is available in front of the Fairgrounds Office.
All pets MUST be on a leash. No pets in buildings. PETS POOP - YOU SCOOP
Refunds will be made (minus $10.00) OR full amount transferred to the next Arkansas RV Rally if requested 30 days in advance.
Pre-registration with fees must be received by March 25, 2022 GAMES BEGIN ON WEDNESDAY, APRIL 13
First Name _________________________Spouse's Name______________________Last Name__________________________
Street Address___________________________________________ City________________________________
State/Province______________________ Zip/Postal Code____________________
Home Phone___________________________________ E-Mail_____________________________________
Good Sam Member Number _________________________Expiration Date ____________________
If you are a member of an Arkansas Chapter, Chapter Name ________________________________________________
First State RV Rally? Yes_________ No________First Arkansas RV Rally? Yes________ No________
Do you require Handicap Parking? Yes_________ No________ HC#____________________________
Children's Names and ages attending (under 18 - no charge) _____________________________________
Please refer to the appropriate RV Rally fee amounts:
1 Rig with 2 Adults, Pre-registered $75.00 $______________
1 Rig with Single Adult $65.00 $______________
Worker's Special: Friday & Saturday $55.00 $ ______________
Each Additional Adult $15.00 $ ______________
If not Pre-registered, $5.00 will be added $ ______________
Enter the total fees included with this pre-registration form: $ ______________
Make check payable to: Arkansas GS/Treasurer and Mail form to:
Helen Tinkle, Registrar 96 Grant 533, Hensley, AR 72065
Phone: 501-680-3398 Email: Helen.firstname.lastname@example.org
Your cancelled check will serve as your receipt - no confirmation will be sent.
By your signature, you understand and agree to abide by the terms and conditions indicated below:
I/We the undersigned understand the Arkansas Good Sam Organization has taken reasonable and necessary
safety precaution and I/We accept full responsibility for the welfare of my/our unit and all persons therein while
attending theArkansas RV Rally.
The Arkansas Good Sams reserves the right to refuse registration and/or admission to anyone.