Round Engine Rodeo Hartford Weekend Registration Form July 26—28, 2013 Name of Pilot:_________________________________ Passenger(s):_________________________________ Address:__________________________________________________________________________________ City:___________________________________________ State:__________ Zipcode:__________________ Phone: ______________________________________ Email:_______________________________________ Emergency Contact Name:__________________________________________________________________ Phone: ______________________________________ How are they related?_________________________ Aircraft Make & Model:____________________________________________ N Number:_______________ When do you plan to arrive at Hartford? (circle one)
Friday, July 26
or
Saturday, July 27
Dinner will be available both Friday and Saturday, however pre-purchase will be required to ensure you have a meal. Friday Dinner: Fish Fry on the Fly (a tradition on Fridays in Wisconsin)
Saturday Dinner: Old Fashioned Pig Roast
$12.00 each # of dinners _____ Total $ ______
$17.00 each # of dinners ______ Total $ ______
Saturday and Sunday a local youth aviation group will have a pancake breakfast available for purchase. Lunches will be available for purchase on the field Friday and Saturday.
Total Food $__________ T-shirts have been made to remember the occasion. The cost is $18 each. Please indicate quantity and sizes desired.
S _____ M _____ L _____ XL _____ 2XL _____ Total T-shirt $_________ Registration and Camping Info: Registration is $20 for pilot and aircraft; it is $5 each additional person in aircraft or in chase car camping with you. Will you have a chase vehicle that will be joining you to camp?___________ Total people camping with you: _______
Total Registration $_________ If you do not plan to camp with your plane local hotels are: AmericInn 262-673-2200 Super 8 262-673-7431 Westphal Mansion 262-673-7938 Jordan House B&B 262-673-5643
Please add all costs and include payment to: S&S Aero Works, 1002 Heather Lane, Hartford, WI 53027 Payment options: Check/Money Order made out to S&S Aero Works, Mastercard or Visa. Visa/Mastercard# ________ /________ /________ /________ 3 digit Verification #_____ Expiration date: ____/_____ Print name as it appears on the card: _____________________ Signature: ____________________________________
Total Enclosed $_________ Dinner payments and registration are non-refundable. Questions? Call Dana Osmanski 262-966-7627 If weather prohibits the event S&S Aero Works will mail t-shirts to the registered person. Registration deadline is July 18th! DON’T FORGET TO BRING YOUR TIE DOWNS!