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Closed Tour For: Alamo A’s - 1969 MARC A’s - 1969 Piney Wood A’s - 1987 th Victori-A’s – 1974 46 Annual Poor Boy Tour Hosted by the Greater Houston Model A Restorers Club Gonzales, Texas * April 4-5, 2014

Registration Fee: $30 per adult ($40 after March 1, 2014) No Charge for immediate family children under 18 years

Name of attendee Adult Child ______$ 30 ______$ ______$ _____ $ N/C ______$ _____ $ N/C Total $ _____

______Address City, State, Zip ______Cell Phone E-mail

Model A Year: ______Body Style ______Will you have a trailer? Yes ____ No _____

Club Affiliation (Circle One): Alamo A’s, Houston A’s, Piney Wood A’s, or Victori-A’s

Registration check-in and hospitality room located at the Holiday Inn Express in Gonzales. The Friday and Saturday evening meals are at the First United Methodist Church, 426 Saint Paul Street

Friday Evening Meal: Number of Fried Catfish ___ Saturday Lunch: Brown Bag at First United Methodist Church Saturday Evening Meal: Number Roast Beef ___

Please make check payable to: Greater Houston Model A Club . Send check and registration form to: Doug Busker, P.O. 24514, Houston, TX 77229 Contact information: 713-202-2935

Accommodations: (Please mention” Poor Boy Model A Tour” for special rate until Mar 1, 2014)

Holiday Inn Express 126 Middle Buster Rd (830) 672-2777 King or 2-Queen $120.00 Sleep Inn & Suites 2138 Water Street (830) 672-1888 King or 2-Queen $110.00 Days Inn & Suites 2131 Water Street (830) 519-4353 2-Queen $99.00 Microtel 2019 Water Street (830) 203-5110 Double or 1-Queen $99.00 Best Western 1811 Sarah DeWitt Drive (830) 672-5555 Double $139.00 RV Parks: 4 L RV Ranch 26 Lucas Lane (Hwy 90A) (830) 672-6057 4lrvranch.com Eagle Ford RV Park 5784 US Hwy 90A (210) 858-8280 www.eagleford-rv.com

I hereby release Greater Houston Region Model A Restorers Club, Model A Ford Club of America, Model A Restorers Club, including organizers and sponsors of this tour and their facilities from any and all liabilities. Submittal of this form, whether signed or unsigned constitutes acceptance of this release.

Signed: ______Date: ______