Please Come Join Us At The Fabulous Las Vegas Motorcoach Resort For POG XI

October 1 to October 5, 2012

Last Name_________________________________________First Name_________________________&______________________

Address____________________________________________City_____________________________St__________Zip____________

Email_______________________________________________POG Handle_______________________________________________

Shirt Sizes________________________&______________________

Amount Due

Rally Fee ( 2 people ) $ 599 per Coach _______________________

Rally Fee       No Coach $ 175  per person _______________________

Cirque Du Soleil Dinner Show $ 90 per person _______________________

Additional Guests $ 150 per person _______________________

Total Due _______________________

Please send Registration Sheet & Payment to :

POG

26012 Splendid Meadow Ct.

Astatula , Fl 34705

If you prefer to pay by credit card please send this sheet in and write Credit Card next to Total Due – you will be sent a payment link.

Cancellation Policy : Cancel by 9/1/12 - 100% refund – cancel between 9/1 and 9/21/12 - 50 % refund – cancel after 9/21/12 - sorry – no refund.