TIDEWATER COIN AND RELIC CLUB

WELCOME TO THE

TIDEWATER COIN AND RELIC CLUB

21^st ANNUAL OPEN HUNT

MAY 17, 2008

LITTLE CREEK AMPHIB BASE, NORFOLK, VA

Registration Form

NAME:
ADDRESS:
CITY/STATE/ZIP:
TELEPHONE #:
EMAIL ADDRESS:

Do you have military stickers to allow you on the base? Check One --YES NO

Due to Government Regulations you will also have list all Passangers coming on Base with you to the Hunt.

If NO, please furnish vehicle info:		Passanger List
YEAR:
MAKE:
MODEL:
LICENSE PLATE:

I release TIDEWATER COIN AND RELIC CLUB (TC-RC), Staff, and all hunt sponsors from claims arising from loss or theft of personal property and personal injury. I also agree to release any photographs of myself that may be used for journalistic purposes on TC-RC's website.

Name:
Signature:
Date:

Please send checks payable to: Tidewater Coin and Relic Club (TC&RC) mail with form to:

Tidewater Coin and Relic Club
21st ANNUAL OPEN HUNT
P.O. Box 3462
Virginia Beach, VA 23454