APPLICATION DATE _________________________
LAST NAME_________________________ FIRST NAME________________________ MI________
SPOUSE __________________________________ ANNIVERSARY DATE________________________________
BIRTHDAY (DAY AND MONTH) __________________________ SPOUSES BIRTHDAY __________________________
MAILING ADDRESS ______________________ CITY_________________ STATE ____ ZIP___________
GOOD SAM MEMBERSHIP NUMBER __________________EXP. DATE________________________
TELEPHONE AREA CODE (_______) ___________________
OTHER CAMPING CLUB MEMBERSHIPS_____________________________________________________
It is the purpose of this chapter to operate a social organization to promote the use and enjoyment of Recreational vehicles and outdoor fellowship among its members through trips and group activities This Chapter shall maintain an attitude which is strictly non-sectarian, non-partisan, non-sectional, and non-racial and shall be dedicated to bringing together people interested in the ideals and principles of the International Good Sam Recreational Vehicle Club.
information
TYPE OF RV: (Circle One)
MOTORHOME 5TH WHEEL TRAILER POP-UP OTHER
BRAND NAME AND LENGTH______________________________________________ YEAR____________
MEMBERSHIP DUES
A membership fee of $25.00 will pay your dues for one year. Membership dues are non-refundable in event of membership cancellation. Dues must be paid to the chapter treasurer within 30 days of notification of acceptance for Chapter membership, and annual thereafter by the date specified in the operating rules.
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THE GOOD SAM PLEDGE
I will stop and give aid to fellow Good Sam members where safety and traffic conditions permit. I will not attempt to stop and give aid on turnpikes, freeways or expressways, but instead will give three short blasts on my horn to indicate that I am reporting the breakdown to the nearest highway patrol, toll gate or police department. If i am broken down on the expressway, I will raise the hood of my vehicle to indicate i am in need of assistance and stay with the vehicle until help arrives. I will keep my recreational vehicle in safe condition at all times and give special attention to breaks, tires, and running lights. I will drive within the law and with consideration of others. I will watch following traffic on up-grades and pull off the road as soon as possible whenever i am causing a slowdown. I agree to observe and cause to be observed all posted rules and regulations for the betterment of the enjoyment of outdoor recreational facilities. I will leave my campsite in BETTER condition than i found it. I will try to wear a smile like a Good Sam and promote the objectives of the Good Sam Club whenever i meet other RV owners.