*  Have you read and do you understand the online registering requirements?

Yes No (If NO, please stop and re-read the instructions)

*  Choose the  Louisiana Samboree you are registering for:

Fall
Spring

Please enter your anticipated arrival day: This is just to give us a daily estimate.

*  Please provide the following contact information:

*Last Name
*First Name(s) His & Hers
*Chapter # & Name Enter 'At Large' if you do  not belong to a chapter
*Street Address
Address (cont.)
*City
*State/Province
*Zip/Postal Code
*Home Phone
*E-mail
*Re-Enter E-mail Do they match?

*  Please enter your Good Sam ID number and expiration date:

Is this your first Samboree?

Yes No

Is this your first Louisiana Samboree?

Yes No

Enter children's names & ages in the space provided below. (No charge under 18).

*  Choose your registration type:

State Staff
Host Chapter
Other Special Comp
Vendor or other non-site lodging registration

If you wish to be parked with a certain state or chapter group, please indicate below

I/WE understand the Louisiana Good Sam Organization has taken reasonable and necessary precautions and, therefore, I/WE accept full responsibility for the welfare of my/our unit and all persons in my/our unit while attending this Louisiana Samboree.

The Louisiana Good Sam Organization reserves the right to refuse registration and/or admittance to anyone.

*  If you agree with all of  the above terms and conditions of your registration and attendance
 type 'yes' or 'no' (in lowercase only) in the box below.

Did you find registering online easy?

Yes No

What would you suggest we change or add to make this type of registration easier?

BEFORE YOU HIT THE 'SUBMIT' BUTTON, PLEASE RECHECK YOUR FORM AND MAKE SURE THAT YOU HAVE COMPLETELY FILLED IN THE FORM !