2021 Sholes Family Reunion Registration Form

Please be sure to complete the entire form and return it with your registration fees

REGISTRATION DEADLINE: FEES

05/25/21
Adults 13-100 $85
Pre-Teens 7-12 $
75 $30
Child 3-6 (infants free)
 REGISTRANT’S INFORMATION
Name: Phone:
Address: Email:
City: State: Facebook:
Zip:

REGISTRATIO
Name and Age Adult $85 Pre-Teen Child $30 Amount
$75

Example: Jane Doe – 28 85.00 85.00

1. $
2. $
3. $
4. $
5. $
6. $
Subtotal Registration: $
T-Shirt Sizes: Child: XS(2-4), S (4-6), M (6-8) L (10-12) XL (14-16) Adult: S, M, L, XL, XXL, (XXXL,
XXXXL
Name:additional $5) Color
Name: Color
Name: Color
Name: Color
Name: Color
Choose your color and mark W for women’s cut shirt. Colors:
Payment Options (check box)  Cashier’s Check  Money Order ☐ PayPal 
Venmo

PayPal Email Address: _______________________________________________________

Dietary Needs: ☐vegetarian ☐vegan ☐diabetic

Please list food allergies:

Signature: ________________________________ Print Name:
_________________________

Family Line: ________________________________________

Interested in participating in
󠄉 Family Talent Show Talent: ___________________________________________________
󠄉 Family Line Dance Dance Music: ______________________________________________
󠄉 Casino Night Out Number of People:(21& older) __________________________________

Mail this form to: Karen Holmes-Mura * P.O. Box 1897 * La Mirada, CA 90637
Please make copies of this form or forward registration packet by email to family members that we may have missed.