2012 MAN. & N.W. ONT. SAMBOREE 2012 
PORTAGE la PRAIRIE, MANITOBA
"OUR STRAWBERRY ISLAND SAMBOREE"
May 30 - June 3
All Good Sam Members and Guests Welcome
Early Bird starting 9:00 a.m. May 29, 2012 @ $10.00/day
Handicap parking must have handicap sticker displayed when arriving.
All parking will be at the discretion of the wagonmaster.
2 persons/dry camp/banquet.........$100.00
1 person/dry camp/banquet...........$85.00
Additional adult/banque.................$35.00
Teenagers/banquet.......................$30.00
Activities: Cribbage, Entertainment, Games, Golf, Jam Sessions, Tours, and Fun
Food: potluck Supper-Wednesday Breakfast & Catered Banquet Supper - Saturday
Registration Cancellation Fee $10.00 after May 1, 2012
No refunds for cancellations the week of the Samboree
All registrations must be paid in full by April 30, 2012 - After April 30/12 - $105.00
No postdated cheques
Your cancelled cheque is your receipt
Cheques made payable to: MAN. GOOD SAM
Mail to: Sharon Burke 6-96 Stradford St. Winnipeg, MB R2Y 1T7
PH: 204-837-5388 E-mail address: barshar@mts.net
Name:___________________________________Spouse__________________________
Address:____________________Location____________Prov/State_______P.C./Zip________
Good Sam #____________Exp.______Chapter Name:___________________________________
Additional: Guests:___________#of Children_________Children's Age__________
Rig Type: M/H ______5th________T/T_______Length_________#of slides_____
Early Bird: Tuesday, May 29, 2012___________ Handicap Parking:_______________
their unit while attending the Man & NW Ont Provincial Samboree and hold harmless the
MAN & N.W.ONT. Provincial Good Sam Organization for any claim for personal injury
by members or damage incurred to their unit. Signature_____________________________________________________________________