State Rally Registration By filling out this form, you are pre-registering for the 2021 Texas State Rally!! *Fill out this form and click "register" button below to send to registrar *Send check for fees (see fee table on previous page) to: Sue Powell Texas Good Sam 196 Rainbow Drive #9670 Livingston, Texas 77399 Pilot Name (Last, First) (required) Pilot's Cell Phone: (NPA NXX-XXXX) (required) Pilot's Email: (someone@domain.com) (required) Navigator: (Last, First) Navigator's Cell Phone: (NPA NXX-XXXX) Navigator's Email: (someone@domain.com) Your Address: (address, city, state, zip) (required) Your Chapter (chapter or none) Emergency Contact Name: (First Last) (required) Emergency Contact Phone: (NPA NXX-XXXX) (required) My First Rally: NoYes Enter Cowboy Stew Cook-off: NoYes Parking Standard ParkingHandicap Parking(Decal Required)