Northeast Chapter       Falcon CLUB OF AMERICA PRESENTS THE 24th ANNUAL       REGIONAL FALCON MEET                                                                                       August 18 & 19, 2023 at the Publick House                                              277 Main St. (Rt. 131), Sturbridge, MA Meet and Banquet Registration Form Name: ________________________________________ Spouse/Guest: _______________________ Address: ___________________________________________________  City: _____________________ State: _____________________  Zip:  _________________  Phone: (         ) ___________________ Falcon Registration Information Vehicle Year: __________  Model: _______________________  Body Style: ______________ Color: ________________Engine:________ Stock:  _____   Lt. Mod:______  Modified:_____
                 Falcon Registration Fee: $20.00                                1 @ $____________                or Special Daily Driver Class: $15.00                                            1 @ $ ____________                 Banquet: Saturday August 19, 2023 at 6:00 pm                           #  ______ @ $42.00                                                 Turkey Dinner #__________    Pot Roast      #_______                                                               (We are limited to 50 people for the banquet so please register early)                VENDOR SPACE FEE: $20.00                                                   1 @ $ ___________              T-Shirts: Sm. _______ Med. ______ Lg. ______ X-Lg. _____  XX-Lg. ______       Sm.,Med.. Lg.,  X-Lg $20.00 each     XX-Lg $22.00 each        $_______________             Total Falcon Registration, T-shirts & Banquet Amount: $ ___________     For Hotel registrations call the Publick House at 508-347-3313 Room rates are $115.00 plus tax per night     guaranteed until July 14, 2023.  (You must mention Falcon Club Show when making your reservations.)                         Send this form and remittance payable to: Northeast Chapter FCA,                             c/o Cristine Bowes, 552 Franklin Road, Coventry, RI 02816          For more information, contact Cristine Bowes at (401) 529-2622 or falconsprint@aol.com                                                             WAIVER OF LIABILITY                             Print Name                                                                                          Sign Name
I agree not to hold the Northeast Chapter, the Falcon Club of America, or the Publick House responsible for losses, damages, or injuries while at this Convention