You may fill out this form online, print and mail in your pre-registration fees. Please refer to and print the appropriate Samboree page for full Samboree fees,
contact methods and future reference. Make check payable to: Louisiana Samboree
Mail form to: Marcia Dial, 120 Chestnut Blvd,
Pineville, LA. 71360
Which Samboree are you registering for?:
What is your anticipated date of arrival?: First Name (his & hers)Last Name
Street AddressCity State/ProvinceZip/Postal CodeHome Phone
confirmation information will be sent via email.
Enter your Good Sam member number: Expiration date:
Enter your chapter name.
Are you registering as an 'At Large' member?
Is this your first Samboree?
this your first Louisiana Samboree?
Enter children's names & ages (under 18-no charge).
Please refer to the appropriate Samboree page for fee amounts and offerings to
be entered below! Enter your Samboree fee:
Enter the amount for each additional person over your rig fee:
Enter your At Large fee if you are registering as an At Large member:
Enter any other fee(s) that is(are) offered:
Other fee(s) description:
Enter the total fees included with this pre-registration form:
By your signature you understand and you agree to abide by the terms and
conditions indicated below.
I/WE understand the Louisiana Good Sam Organization has taken reasonable and necessary
precautions and, therefore,
I/WE accept full responsibility for the welfare of
my/our unit while attending the above indicated Louisiana Samboree.
The Louisiana Good Sam Organization reserves the right to refuse registration
and/or admittance to anyone.