Start Date: 2026-08-12       Departure Date: 2026-08-22

Elkhart Campground

• Address: 25608 Co Rd 4, Elkhart, IN 46514
• Phone:
• For Reservations Contact: HQ

Sponsor(s): Central Region

Host: Lisa Duckworth     Phone: (501) 772-4991     Email: ducktwin@gmail.com

Muster Costs:

Single Cost: $100.00   Couple Cost: $200.00   Couple + Guest Cost: $300.00   Camping/night: $70.00  

An entry in all fields shown in the registration form is required.

Pilot:   SMART#:

Copilot:   SMART#:

Home:   Pilot's Mobile:   Copilot's Mobile:

Pilot's Email:

Street

City     State     Zip

In Case of Emergency (ICE) Contact Information

Please provide at least one emergency contact other than your Copilot.

Notify:   Phone:   Relationship:

Notify:   Phone:   Relationship:

RV Information

RV Type:         Make:

Model:         Length:

I tow a vehicle behind my motor home.   Total length of tow and towing vehicles:

Attendees:   One Person $100.00.00   Two Persons $200.00.00   Two plus Guest $300.00.00

I (We) are first time attendee(s).

Guest Name:   Enter guest first and last names or “None.”

Planned Arrival:       Planned Departure:

Camping Costs: $   70.00/night

Luncheons Are you attending the luncheons?

Mens Luncheon:         Ladies Luncheon:         Lunch Total: $

Handicap Parking         30 Amps   50 Amps

Do you or your traveling companion use any of the following, cane, walker, electric wheel chair, scooter, C-PAP?  

If Yes, please indicate which one(s):

Special Diet Needs  

His:  

Hers:

  I will volunteer to help at the Muster

Shirts (S-XL) $28.00 each. Shirts (XXL-4XL) $28.00 each.

Mens Qty:   Size: (Mens Small to Mens 4X)

Ladies Qty:   Size: (Ladies Small to Ladies 4X)

Shirt Total: $

Tours

  Tour#1 President's Cup Golf Tournament - Cost: $0.00

Cost TBD. John Steinbaurer has re-established the Duffers Chapter, contact him for details.   Total: $

  Tour#2 Teaberry Wood Products Plant Tour - Cost: $0.00

Cost TBD. Thurs Aug 13, 10am, return at noon. Family run wood shop featuring hand crafted walnut, cherry and other hardwood items. Plant tour, then make a wooden basket.   Total: $

  Tour#3 Das Dutchman Essebhaus - Cost: $0.00

Cost TBD. Friday, Aug 14 at 10:30am, return at 2pm. Village shops, buffet lunch, explore restaurant, bakery, gift shop.   Total: $

  Tour#4 Menno-Hof Amish Museum - Cost: $0.00

Cost TBD. Sat Aug 15, 9:30am, returns at noon. 25 different venues that will take you into the world of Anabaptists.   Total: $

Liability Release

In consideration for my (our) attendance, I (We) hereby release and agree to indemnify and hold harmless SMART, its officers, directors, employees, agents, successors, and assigns from any and all liabilities, claims, losses, and/or damages arising from my (our) attendance at this event.

All attendees must read and sign this form.

Total Submitted: $_____________________

Please mail a copy of this form along with your check, (payable to SMART), to .