Address_________________________________________________________ City ______________________________ State _____ Zip Code _________
Phone (including Area Code) ____________ Email_____________________
Name ______________________ Circle-one (spouse, son, daughter, mother, father) Age ______
Name ______________________ Circle-one (spouse, son, daughter, mother, father) Age ______
Name ______________________ Circle-one (spouse, son, daughter, mother, father) Age ______
Events # of Persons X Price = Cost Subtotal for each Event
Friday June 25 Banquet: 12 year old to Adult ________ X $17.50 = __________ __________
5 - 11 years _________ X $ 9.00 = __________ __________
Saturday, June 26 -Tour - Lookout Mountain: 18 year old to Adult ________ X $11.00 = __________ __________
4-17 years ________ X $11.00 = __________ __________
-Picnic: 12 year old to Adult ________ X $Free = __________ __________
5 11 year old ________ X $Free = __________ __________
-Skate City: 12 year old to Adult _______ X $7.00 = __________ __________
5 -11 year old _______ X $7.00 = __________ __________
Sunday, June 27 Brunch: 12 year old to Adult _______ X $5.00 = __________ ___________
5 - 11 year old _______ X $5.00 = __________ ___________
Tee shirts: Small____ Medium___ Large___ X Large___ $10 2XL___ 3XL___ $12 ______
Subtotal __________
Annual dues are $25.00 per family (a family is considered head of household and dependents claimed on tax form). $25.00 for dues will be taken of of the top of any amount you send in and you may still have a blanace due whatever Reunion actvities you want to participate in. If you have already paid your 2010 dues - THANKS!!!
