BURNAM SIMPSON FAMILY REUNION REGISTRATION FORM Sheet1 (2) .pdf

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2017 BURNAM-SIMPSON FAMILY REUNION REGISTRATION FORM
Dues & Registration Deadline Date:

JUNE 1, 2017

REUNION DUES

Attendees First & Last Name

Age

Price Per
Person Quantity Subtotal
Adults

Age: 18+

$40.00

$

Youth

Age: 13-17

$15.00

$

Children

Age: 0-12

$0.00

N/A

Additional
PER
Fee *
$10.00 PERSON
*for reunion event expenses

$
Please attach another sheet for additional attendees

TOTAL DUE
Make checks payable to: Carol Miller

Contact person for your registration:

Mail check AND form to: Carol Miller
19334 Stansbury St.

Name:

Detroit, MI 48235
313-341-3249- home

Phone number:
313-492-7536-cell

Hotel Reservations for Springhill Suites Marriott
Will reserve rooms for: __________ 7/7/17 __________ 7/8/17
Attending Friday Night Welcome:

___________ # of people attending

____________ I/we will NOT be attending

Saturday Family Reunion Event:

___________ # of people attending

____________ I/we will NOT be attending

Saturday Night Bowling:

___________ # of people participating

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