Adults Names*: ________________________________________________________________
Keets Names & ages*: ___________________________________________________________
Address: ________________________________________, City: ________________________
State:_________ , Zip: ______ Home Phone: __________________ Cell Phone: _________________
E-Mail: _____________________________ Parrot Head Club: ___________________________
______ Not in a club, but want to join the PHUN!!!
* Full info necessary (include any desired nicknames) for your badges that will give you entry to the events.
Camping Info:
IMPORTANT: We have reserved a very large area for the event in the group area. You will pay White’s for your campsite upon your arrival at the campground. Here are the campsite fees you may expect to pay: per person per night, if tubing, if not tubing. per family per night, if tubing, per family per night if NOT tubing. Do not contact White's for a reservation as the spots are already reserved by PP5.
We absolutely need to know:
When will you arrive? Thursday, Friday, Saturday (circle one) Approximate time of arrival? am/pm
Will be camping in a _________________________________________________________________________
(include size of tent or camper)
We want to camp by: __________________________________________________________________________
(insert person's name or club name)
We HAVE to have electric: ____ Potable water is available at the shower house, not at the sites.
Note: Loooong, heavy duty extension cords and multi-plug surge strips are highly recommended.
FURTHER NOTE that EVERYTHING in group camping is shared, i.e., electric, the sites (no one gets their very own, specific site all to themselves) as well as picnic tables. We recommend you bring a folding table.
Tubing: $ 7.00 per person
THIS IS ABSOLUTELY NOT REFUNDABLE If you pay and then choose not to go it's YOUR loss.
Saturday 12:00 p.m. How many Adults?_____ Keets? _______
Tubes with bottom $1.00 extra (for keets only) _______
Amount Due for Tubing: $________
Event Registration: $ 30.00 per adult - .00 if registered after April 15
How many Adults? ______
Keets? ______ (keets are only .00 each and includes a PP4 T-shirt to tye dye)
Amount Due for Registration: $________
T-Shirts - $ 10 each - .00 at event
S_____ M____ L ____ XL ___ extra for: XXL ______ and XXXL __
Amount Due for T-Shirts: $________
Do the Math: Total Amount Due: $$ __________
By my signature I agree to the rules of Parrot Phlock 2005 and White’s Canoe. Further I agree that I am solely responsible for my behavior, no matter how bad or embarrassing it may be and I cannot hold the Parrot Head Clubs that make up the event of Parrot Phlock, White’s Canoe, or anyone affiliated with Parrot Phlock, their officers or members responsible for any mess I get myself and those in my party into.
I FULLY UNDERSTAND THAT THIS REGISTRATION IS 100% NON-REFUNDABLE - INCLUDING T-SHIRTS AND TUBING
Please sign here: ______________________________ _____________________________________________
Please make check payable to: Pirates of the Great Lakes (PotGL)
Mail to: PP5-Mitch Mihailuk, 16346 Hilltop Linden 48451 810-735-9494
