Registration Form

March 2017
Please complete and return by April 30, 2017 to Branker Reunion, c/o Theresa Howell,
61 Court Street, Medford, MA 02155, Tel: (781) 395-4140; or c/o Albert Thompson, 4802 Caton
Woods Court, Dover, FL 33527, Tel: (813) 754-8419; email albertthompson33@gmail.com

Name: _________________________________________________________________
(Please type or Print)

Parents/Grandparents Name: ___________________________________________

Name, City & State
For Nametag: ______________________________________________________
Home Address: __________________________________________________________
(Street) (City) (State) (Zip)
Home Telephone: __________________________Cell/Beeper: ___________________
Business Telephone: (optional) ______________________________________________
Email: _________________________________________________________________
Spouse/Guest Name
And city for nametag: ________________________________________________;
Childrens name/s and ages: _______________________; _____________________;
__________________________; _______________________; ____________________;
Please check the events you (and guest/s) will be attending, and write in the applicable costs.
If you already paid for registration and T-shirts, add a zero on the cost line.
Attending Cost
All Prices in US dollars
Thursday --Registration Fee $15.00 per person ________ $_____________
Thursday -- Luncheon $25.00 per Adult _______ $___________
$15.00 (children 5 to 10 years) _________ $___________
Friday -- Island Tour (All inclusive) $55.00 per person _______ $___________
$40.00 (children 5 to 10 years) _________ $___________
Saturday -- Banquet Dinner $65.00 per Adult _______ $___________
$30.00 (children 5 to 10 years) _________ $___________
Sunday -- Church Service
Beach Picnic (include trans. & meal) $25.00 per Adult _________ $___________
$15.00 (Children 5 to 10 years)_______ $_______________
Total Amount $___________
T- Shirts $15.00 per person ___________ $___________
(Sizes S,M,L,XL)
$17.00 per person (XXL, XXXL)________ $_____________
Total $__________
Please return this registration form along with payment for events by April 30, 2017 made out to Branker Family
Reunion. This will help us to determine the number of attendees. Full amount of your reunion package is due by
May 15, 2017 (but would appreciate if paid before date due). Money order or cashiers check only.
children 4 and under are free for all events and they must be seated on someones lap on the
bus for the Island Tour and the Banquet.