Registration Form

Return with check or money order (made to Clan Egan Rally) to James Eagen, 4610 Brad Court, Rockville,MD 20853. Reservations & Payments are due as soon as possible.

Family Name:________________________ Family Address: ______________________ _____________________________________

Telephone number:_(____)____________

Names for those 18 and over:

___________________________x $20.00
___________________________x $20.00
___________________________x $20.00
___________________________x $20.00	Subtotal:______

Names and ages for those under 18:

Name	Age	Name	Age
___________________	______	______________________	______
___________________	______	______________________	______
___________________	______	______________________	______

Beds (two twin beds per room, some singles) for each day:

Friday	Saturday	Sunday	Monday
__________	__________	__________	__________	Total___ x $35=	Subtotal:_____
				Max # beds on any night x $17=	Subtotal:_____

Bus Seats Monday

#___________ x $8 =

Subtotal:_____

Banquet Tickets:	Saturday night
	Age 18 and over: #______ x $35 =	Subtotal:_____
	Under age 18: #________ x $25 =	Subtotal:_____

Crabfeast Tickets:	Sunday afternoon/evening
	#_____ x $35	Subtotal:_____

Meal Tickets:

	Friday	Saturday	Sunday	Monday	---------------
Breakfast	_________	__________	__________	_________	Total x $4 =	Subtotal:_____
Lunch	_________	__________	__________	*________	Total x $5 =	Subtotal:_____
Dinner	_________	*_________	*_________	_________	Total x $8 =	Subtotal:_____

*Do not schedule if taking bus, attending banquet, or attending Crab Feast

Aodagain T-shirts:

______	small	x $11 =	Subtotal:_____
______	medium	x $11 =	Subtotal:_____
______	large	x $11 =	Subtotal:_____
______	X-large	x $11 =	Subtotal:_____
		Grand Total Check	_______________

Please add note for any disability accommodation necessary, and we will try to arrange for it.