Northeast Chapter
Falcon CLUB OF AMERICA
PRESENTS THE 24th ANNUAL
REGIONAL FALCON MEET
August 18 & 19, 2023 at the Publick House
277 Main St. (Rt. 131), Sturbridge, MA
Meet and Banquet Registration Form
Name: ________________________________________ Spouse/Guest: _______________________
Address: ___________________________________________________ City: _____________________
State: _____________________ Zip: _________________ Phone: ( ) ___________________
Falcon Registration Information
Vehicle Year: __________ Model: _______________________ Body Style: ______________
Color: ________________Engine:________ Stock: _____ Lt. Mod:______ Modified:_____
Falcon Registration Fee: $20.00 1 @ $____________
or Special Daily Driver Class: $15.00 1 @ $ ____________
Banquet: Saturday August 19, 2023 at 6:00 pm # ______ @ $42.00
Turkey Dinner #__________ Pot Roast #_______
(We are limited to 50 people for the banquet so please register early)
VENDOR SPACE FEE: $20.00 1 @ $ ___________
T-Shirts: Sm. _______ Med. ______ Lg. ______ X-Lg. _____ XX-Lg. ______
Sm.,Med.. Lg., X-Lg $20.00 each XX-Lg $22.00 each $_______________
Total Falcon Registration, T-shirts & Banquet Amount: $ ___________
For Hotel registrations call the Publick House at 508-347-3313 Room rates are $115.00 plus tax per night
guaranteed until July 14, 2023. (You must mention Falcon Club Show when making your reservations.)
Send this form and remittance payable to: Northeast Chapter FCA,
c/o Cristine Bowes, 552 Franklin Road, Coventry, RI 02816
For more information, contact Cristine Bowes at (401) 529-2622 or falconsprint@aol.com
WAIVER OF LIABILITY
Print Name Sign Name
I agree not to hold the Northeast Chapter, the Falcon Club of America, or the Publick House responsible for losses, damages, or injuries while at this Convention