Ely High Class Reunion Registration Form

FirstName:_________________________LastName:_______________________________

Address:____________________________________________________________________________

City: ____________________________________ State: _____Zipcode:___________

Phone: ___________________email: ______________________________________

***Itnerary***

Friday, June 17^th – Meet and Greet- Blue Martini (Sunrise) @ 5:00pm

Happy Hour Half Off the Menu between 2pm-8pm 

Saturday, June 18^th – Banquet at Royal Fiesta_____  Number attending: __________

$50.00 per person (Semi-formal Dining)

 Includes salad, entree, (2) sides, dessert and (4) hour open bar

Payment Plan Options: $25.00pp due  March 11^th, and the final payment of $25.00pp due by April 5, 2011. 

**If you have any questions, please feel free to contact Willie Humphrey @ (954) 675-6912 humphrey_junior_gotcha@yahoo.com or Regina Young @ (954) 692-4156 reginayoung17@yahoo.com.