MOG 36 REGISTRATION

Clarion Inn, 233 Lowe Drive, Shepherdstown , West Virginia  304-876-7000

JUNE 30^TH – JULY 4^TH

Mail Registrations to: Millie Adams, 1701 North Pocomoke Street, Arlington, VA 22205

MOG 36 fees can be paid by check drawn on a US bank, or charged to a Visa or MasterCard

Checks should be made out to MCCDC.

Please Print Information Legibly

Name:_______________________________________ Others in your party :1)______________________________________

2)__________________________________3)__________________________4)_____________________________________

Address:__________________________________  City: _____________________State: _______________Zip:___________

Country:________________ Home Phone: ____________________Cell Phone_________________ Other:_______________

Club Affiliation:_______________ Arrival Date:_______ Departure Date:_______  E-Mail Address: ____________________

I volunteer to help with the following: Circle your choices:

1) Registration     2) Concours     3) Rally     4) Autocross      5) Gymkhana     6) Noggin Fun and Games     7) Regalia Store             

Morgan(s) Information

Year                   Plate#                   Serial #            Model           Body Style        Color(s)         Interior

_______          ___________         ___________     ______       _____________    _________     _______

_______          ___________         ___________     ______       _____________    _________     _______

_______          ___________         ___________     ______       _____________    _________     _______ 

Registration / Events/ Meal Fees

* 50% off Primary Registration fee if your car is registered outside of the “48 states.”                 

* $135 Primary Registration for MCCDC members                                                    Before June 1, 2006                               After June 1, 2006 

Primary Registration: includes all events for 2 people and 1 Morgan                 $150* _________                       $165  _________

Single Day Registration 2 people and 1 Morgan      Date ________                  $ 50     _________                       $ 65   _________

Additional Adults 16 and older                                                                                 $ 50     _________                       $ 65   _________

Additional Cars                                                                                                            $ 50     _________                       $ 60   _________

Meals per person, Children under 8 y/o are free, children 9-16 y/o half price.

June 30^th Welcome 4/4 Birthday Picnic                                                                     $ 20     _________                       $ 25   _________

July 1^st Concours Lunch                                                                                             $ 16     _________                       $ 21   _________

July 3^rd Autocross Picnic                                                                                            $ 16     _________                       $ 21   _________

July 3^rd Banquet                                                                                                           $ 32     _________                       $ 37   _________

MOG 36 Tee Shirts    S_____ M _____ L _____ XL____ XXL ____            $   8     _________                       $ 12   _________

Beer Glass                                                                                                                    $   4     _________                       $   8   _________

MOG Badges                                                                                                                $ 45     ­­­_________

                                                                                                              TOTAL   $    _________                       $     __________

Regalia:  Shirts and Beer glasses  may not be available after June 1,2006 -  “ MOG 36 Logo “