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Name Required Address State Zip City Country Home Phone Required Cell Phone Email How did you hear about us? Previous Visit Friend or Relatives Woodall's Directory Trailer Life Directory Other Are you a Good Sam member? (Can be purchased at time of registration) Yes No If yes, please indicate Good Sam # Rig Model? Type of RV? Motor Home Class A Motor Coach Diesel 5th Wheel Trailer Travel Trailer Class C Motor Home Class B Motor Home Pop-Up Truck Camper Van Cabin Cottage Length of Rig If Rig is 5th wheel or Travel Trailer 2 dr pickup 2dr pickup ext cab 4 dr pickup SUV Freightliner or similar Towing? Vehicle on Tow bar Vehicle on Tow Dolly Vehicle on Car Hauler Vehicle in Box Trailer Cargo Trailer Do you have a slide out? Yes No Do you want Cable TV? Yes No Do you need 50amp? Yes No Number of vehicles other than rig and tow? Number of people in your party 4 yrs and older? Number of Dogs? Breed of Dogs. Requested arrival date (M/D/Y) Requested departure date (M/D/Y) Payment method: Credit Card - We will call you within 24 hours Check - Please mail check within 24 hours How would you like confirmation? Mail

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