VAN RIPER FAMILY
REUNION
REGISTRATION FORM
Early Deadline:
March 15, 2014*
Final Deadline:
April 14, 2014
*Early Registration family
members will be entered into a drawing for a prize at the family reunion. Payment
must be received by the deadline of March 15, 2014 to be entered.
CONTACT INFORMATION
NAME
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ADDRESS
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ADDRESS CONT.
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CITY, STATE, ZIP
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PHONE NUMBER
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EMAIL ADDRESS
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FAMILY MEMBERS ATTENDING
NAME
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AGE ON 07/09/14
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SHIRT SIZE (YOUTH/ADULT)
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PRICES:
AGE
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2 AND UNDER
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3 & 4 YRS. OLD
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5-11 YRS. OLD
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12 AND UP
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PRICE
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$20
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$45
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$70
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$85
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I HAVE ENCLOSED A POST
OFFICE MONEY ORDER FOR THE AMOUNT OF $_________.00
PLEASE MAIL MONEY ORDERS AND THIS FORM TO:
NAIMA ROYAL
1211 PADDOCKS WAY
