Updated - Oct 14,2023
Regional Registration Form
Northeast Ch
apte
r
Falc
on
CLUB
OF
AMERI
CA
PRESEN
TS
T
HE 2
2
n
d
AN
NUA
L
RE
GION
A
L
F
A
L
CON MEE
T
A
ugu
st 20
&
21, 2021 at th
e C
row
n
e
Plaza
Hot
e
l
801 Gre
en
w
ich
A
v
e
.,
W
arwick, RI 02886
Meet
an
d
Ban
q
ue
t
R
egis
t
r
a
t
io
n F
o
r
m
Name
: ______________
____________________
______Spou
se/Gu
es
t: __________
________________
A
ddress: _______________________________________________ C
ity
: _________
______________
State
: _________
_________
Zip: ________________ Ph
on
e
: (
_
_
_
___) ____________________
Falcon R
eg
i
s
t
r
a
t
io
n
I
nf
o
r
m
a
t
i
o
n
V
ehicle
Y
e
ar: ___
____
__
Model
: ____
____
_______
_
______
Bod
y Style: _
__
___
__
____
_______
Color
: _
_
__
___
_
__
___
___
En
gi
n
e:
__
_
__
___
__
Sto
ck:
__
___
Lt.
Mod. __
_
___ M
odifie
d ______
Fa
l
con Regis
tr
a
t
i
o
n F
ee
:
$
20.0
0
1 @ $_______
____
_
o
r
S
p
ecia
l D
ail
y D
r
i
ve
r
Cl
a
s
s
:
$1
5.00 1 @
$ ____________
Banquet:
Satur
day
Au
gust 21, 2
021 at
6:00 p
m
______
@
$3
6.0
0
$
. Stuf
fed B
oneless
Chic
ken Breas
t
#__
___
__
___
Baked
S
c
rod
_#______
_
VENDO
R S
P
A
CE FE
E: $2
0.00
1 @ $ _
______
____
________
T
-S
hirts
: Sm. __
_
____
M
ed.
_
_
___
_
L
g
.
__
_
_
_
_
X-Lg
.
_
_
_
_
_
XX
-
L
g
.
_
_
_
____
Sm., Med., Lg
., X-
Lg
.,
$18.
0
0
eac
h
X
X-
L
g
.
$2
0.
0
0
e
a
ch
$
_
_
_
_
_
_
_
_
_
_
_
_
T
otal Fal
con R
egist
ration
, T
-
shi
rts
& B
anq
uet
A
mo
unt:
$
____
____
__
_
For H
otel regist
ratio
ns call th
e
C
row
ne Plaza H
o
tel
at
401-732-6000
Gro
u
p C
ode
F
AL
R
oom rates are $
129.00 plu
s tax
per nig
h
t gu
ara
n
tee
d u
n
ti
l
J
u
ly 20, 2021
Y
ou
must men
tion
F
a
lcon Clu
b
S
h
ow
w
h
en
maki
n
g y
ou
r reservati
on
s.
Send this
form a
nd re
mittance
p
ayable t
o:
Nort
heast
Chap
t
er
FC
A
,
c/o Cristi
ne Bow
es,
55
2 Frankli
n Roa
d
, Cove
ntry
, RI 0
2816
For
more in
formation
, contac
t Cristine B
owes
at (40
1) 529
-262
2
or
f
alcon
sprint
@
aol
.com
W
AI
V
E
R
O
F
LIAB
ILIT
Y
I ag
re
e not t
o
ho
ld t
h
e No
rth
east Ch
apt
er
, th
e F
alc
o
n Club
of
Ameri
ca
, o
r t
h
e
Crow
n
e
P
l
az
a
Ho
t
el r
es
p
o
n
sibl
e for
losses
, damag
es, o
r inju
r
ies
w
h
ile
at this
Co
n
v
ent
i
o
n
.
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_
P
r
int
N
ame
S
ign
N
am
e