AMERADA 2016
www.JCIAMERADA.com
"Where Friendship is
International"
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CAMP DEARBORN
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September 09-11, 2016 – 1700 General Motors Road – Milford,
MI 48380
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Registration
Information
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Last
Name:
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First:
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Street
address:
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City:
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State:
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ZIP
Code:
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Home
phone:
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Cell
Phone:
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E-mail:
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Jaycee
Chapter:
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State/Province
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Age: q 21 - 40
q Over 41
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Have
you ever been to Amerada before? Y
N
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How
Many?
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If
No, Who referred you?
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T-shirts
$10 up to XXL, 3X and up $5 more
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q Small
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q Medium
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q Large
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q X-Large
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q XXL
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q 3X q 4X
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WHAT WOULD YOU LIKE TO EAT FOR SATURDAY DINNER?
Provided but you cook your own
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q STEAK
q
CHICKEN q VEGETARIAN
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Events
you're interested in participating in: (Doesn't obligate you)
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q Horse Shoes
q Men Tug of War
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q Women Tug of War
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q Keg Rolling
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q Women’s Beer
Drinking
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q Men Arm Wrestling
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q Pancake Eating
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q Wine Sucking
q Beer Pong
q Texas Hold'em
Poker
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q Pickle Eating
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q Belching
q Team Beer Chugging
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q Volley Ball
q Men’s Beer
Drinking
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q Blind Paddle Boat
Race
q Hairy Chest
Contest
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q Potato Humping
q Women’s Arm
Wrestling
q Pass it On (bring
CPG from a Chapter Project)
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Registration's
Almost free (but not quite) / Onsite Registration CASH ONLY!
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q Early Registration $100 (by April 30,
2016)
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q Standard
Registration $110 (by July 31, 2016)
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q Late Registration
$130 (After
July 31, 2016)
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Registration
includes:
Lodging for Friday and Saturday, Breakfast, Lunch, Cook your own Steak/or
Chicken Dinner Saturday, Breakfast Sunday, Snacks throughout the weekend, Beer
and Soda (Pop) for weekend, Awards and trophies and memories to last a
lifetime. *must be 21 or older
for alcoholic beverages
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Legal Stuff
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By registering and
attending Amerada 2016 you accept responsibility for your actions and are
responsible for any damage you cause. During Amerada some events are athletic
in nature and some are alcohol related, while we are insured, you agree to not
hold any parties including JCI Redford Jaycees and the Michigan Jaycees and Camp
Dearborn, and the City of Dearborn who owns Camp Dearborn, liable for
injuries, loss or damage to personal items.
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Payments:
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_____________________________
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Checks or Money Orders in US
Dollars should be made out to:
Kendra Smyth or paypal: jcsalsa89@gmail.com
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Signature
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Send Payments to:
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Kendra Smyth
c/o Amerada 2016
9976 Appleton Redford, MI 48239
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For more info: Visit www.jciamerada.com
Contact Number 313-717-6589
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