CTGoodSam.com

Please print form below and and return with payment:

NAME________________________________________________                      G.S.#______________________________________________ ADDRESS______________________________________________________CITY____________________________ ST_____ ZIP_____________

RV-Circle One:  M/H   TT   5th   Length________    Make/Model_______________________Registration #_______________________ State___________ Early Registration: Family $80.00         Single $70.00         At the Gate Family $90.00 At the Gate Single $80.00 - AMOUNT ___________ 

#ADULTS_____    #CHILDREN________     #PETS______      # EXTRA ADULT  ______   @ $15.00 each -  AMOUNT ___________

EXTRA NIGHT @ $20.00 each - AMOUNT ___________       DINNERS ADULT #________ @ $15.00 each - AMOUNT ___________

Extra Breakfast Sandwich _________ @ $2.00 each - AMOUNT ____________

NAME OF CONNECTICUT CHAPTER_______________________________________________                            TOTAL ENCLOSED $    ____________ ​ HANDICAP PARKING_______ Send a Copy of Handicap Certificate                              GENERATOR AREA: YES____   NO____ ​

DIRECTIONS TO THE FAIRGROUNDS
From Boston, MA: follow the Mass Pike (I-90) west to exit 10 (intersection with I-290/I-395). Travel south on I-395 into Connecticut. Continue south on I-395 for approximately 16 miles. Take exit 91W onto Route 6 west. Travel west on Route 6 for approximately 4 miles to the intersection of Route 169 in Brooklyn. Turn left onto Route 169 south. The Brooklyn Fairgrounds is 1/2 mile ahead. From Hartford, CT: Travel east on I-84 to I-384 east. I-384 becomes Route 6 in Bolton. Travel east on Route 6 for roughly 40 minutes until reaching the intersection with Route 169 in Brooklyn. Turn right onto Route 169 south. The Brooklyn Fairgrounds is 1/2 mile ahead. From Providence, RI: Travel west on Route 6 into Connecticut. Continue west on Route 6 for approximately 7 miles to the intersection with Route 169. Turn left onto Route 169 south. The Brooklyn Fairgrounds is 1/2 mile ahead. From Norwich/New London, CT: Travel north on I-395 to exit 91. Take exit 91 onto Route 6 west. Travel west on Route 6 for approximately 4 miles to the intersection of Route 169 in Brooklyn. Turn left onto Route 169 south. The Brooklyn Fairgrounds is 1/2 mile ahead. From Stamford, CT: Travel north on I-95  to Exit 76, I-395 this is a left hand exit.  Travel north on I-395 to Exit 91, this is a left hand exit. Take the first exit, for Route 6 west. Travel west on Route 6 for approximately 4 miles to the intersection of Route 6 & Route 169 in Brooklyn. Turn left onto Route 169 south. The Brooklyn Fairgrounds is 1/2 mile ahead.


WAIVER: By submission of this form, I agree in consideration for being able to participate in the Connecticut Good Sam Samboree to release and to indemnify and hold harmless Connecticut Good Sam, it’s Director and Officers from all liability or damages to my  person, property, or injury or damage to persons and their property who accompany me.