Name:________________________________________________________________
Address:______________________________________________________________
City: ___________________________________________State: _____Zip:________
Phone (home): __________________(work):_____________(Email)______________
Names of Attendees (for name tags):
________________________________________
Number of Adult Registrations ____ x $135.00 ($145 after 9/1) $______
Number of Children (free) ____
Colonial Williamsburg 2 Day Visitor Pass for Fri and Sat
_____ x $34 $______
Convention Tee Shirt (specify size) M, L, X, XX
______x$25 $______
Total to Enclose: $______
Will you arrive on
(Circle One):
Wednesday, Thursday, Friday or Saturday
Will you be staying at the Hospitality House Hotel Yes
__ No __
Participate in Thursday
Rally Yes
__ No __
Attend the Thursday Reception
Yes
__ No __
Participate in Friday Driving Tour:
($6/person to Jamestown*)
Yes
__ No __
Participate in Friday Walking Tour Yes
__ No __
Participate in Friday Tavern Dining: (Individual order) Yes
__ No __
Sunday Breakfast, Picnic & Tour Yes
__ No __
* National Park Admission Fee
Are you planning to
bring a 190SL?
Yes __ No __
Year: _______________License No.:________________ State:_______
Body Color: ___________________Interior Color:_____________________
Entering a car in Concours? Yes __
No __; People's
Choice? Yes __ No __
Will you be going on
the "Tour of Virginia" (Oct 19-22)?
Yes
__ No __
Any questions call Jim or Betty Villers at 757-481-6398; email: betty@whro.net
Make Check Payable to: 190SL Group Convention, Mail check to:
190SL Group Convention, c/o Jim
Villers
3133 Inlet Road
Virginia Beach, VA 23454
For Hotel Reservations,
Call the Williamsburg Hospitality House, 1-800-522-2063. Mention the "Mercedes 190SL
Group" when making reservations.