Pre-Registration form for Lake Selmac July 9-10-11-2010

                                                           Sponsors- Rogue Eagles and Rogue Valley Fliers                     

                                                              CD Floyd "Bill" Grove  541-660 6581

Name                                                                                       AMA#                            

Address                                                                                                                       

Phone#                                      

Landing Fee -- $15.00                          Food and Drinks available                 Night Flying

Camp Sites are available

Mail Registration to   Bill Grove

                             685 Galice Rd.

                           Merlin, Oregon  97532