“Growing Up In Rockford” Reunion 2009

Please mail completed registration forms with your check or money order by May 26, 2008 to:
LaTasha Lyons
195 Ruby Ct
Gardena, CA 90248

If paying by Credit Card

1. Email Completed Registration Forms to latasha90815@yahoo.com
2. A payment request form will be sent to you via email.

REGISTRATION FORM

ADULTS:
Name Tshirt size: S ML XL 2XL 3XL
Name Tshirt size: S ML XL 2XL 3XL
Name Tshirt size: S ML XL 2XL 3XL
Name Tshirt size: S ML XL 2XL 3XL

CHILDREN & AGE:

Name Tshirt size: S M L XL
Name Tshirt size: S M L XL
Name Tshirt size: S M L XL
Name Tshirt size: S M L XL

Mailing Address
__________________________________________________
__________________________________________________

__________________________________________________

Phone Number ______________________________________________

Email __________________________________________________

___ I would like to order a Reunion Memory Book for $15 (Complete and send Reunion Book
Information with payment)

___ I would like to make a monetary donation to the Reunion (all donations are used to offset
cost of expenses)

Total Fees Enclosed (check all that apply)

Registration Fee ___ Adult (18 & over) $25 x ___qty
___ Child (3-17) $15 x ___qty

Reunion Book ___$15 x ___qty

REUNION BOOK FORM
Include a photo (optional) past and present.

If you’re not ordering a book, we still would like to include you!

Name:

Maiden Name:

Spouse:

Children Names:

Address:

Phone:

Email:

Share information about your life, family, career, hobbies

If you like, attach another sheet of paper or email your story/picture to latasha90815@yahoo.com

Yes, please include my contact information in the Reunion Memory Book

No, please do not include my contact information in the Reunion Memory Book.

I am not ordering a book at this time, but here is my information to include in the book.