- New York Rangers Fan Club Trip Sign Up -

(Print This Form and Mail To Address Below)

Trip Name & Date ___________________________________________________________________

Please fill out a separate form for each person.

Name:  _________________________________________      Member # _______________________

Street Address:  _____________________________________________________________________

City State & Zip:  _____________________________________________________________________

Phone:     (days) _________________________       (eves) ____________________________
 E-mail:  __________________________________________
 Room if applicable:        ___Single             ___Double            ___Triple             ___ Quad

_______ Smoking           _________ Non-Smoking

Roommates if applicable:

1.  _________________________________________________________

2.  _________________________________________________________

3.  _________________________________________________________


Please mail this form and your full payment (check or money order) to:
New York Rangers Fan Club, Inc.
 G.P.O. Box 8713
New York, NY 10116-8713
 

Attn:  Trips Committee