MHS CLASS OF 1964 - 55TH REUNION
SEPTEMBER 20,21 2019
REGISTRATION / PAYMENT FORM
If you are using this form on a cell phone, we recommend that you turn the phone horizontlly.
You MUST click on the CONTINUE button at the bottom to continue registration
Please provide an Email address allowing an email confirmation of this form to be sent to you.
(not required, but is required for you to receive confirmation)
Graduate's Name:
(First)
(Maiden)
(Last)
Grad's name tag should read:
First
Maiden
Last
Name tag of Guest/Spouse:
Last
First
I will attend both the Friday Reception and the Saturday Dinner Dance at the full weekend price.
There will be
person/people in my party at $120.00 per person for a total cost of
I will only attend the Friday Reception.
There will be
person/people in my party at $45.00 per person for a total cost of
I will only attend the Saturday Dinner Dance.
There will be
person/people in my party at $75.00 per person for a total cost of
Send Payment Form with check for all Events on or before September 1st, 2019.
I am enclosing my TOTAL PAYMENT IN THE AMOUNT OF :
50% refund on cancellation by July 1, 2019
100% refund on cancellation by June 1, 2019
No Refund for cancellation on the Special Offer Full Weekend rate
Please, make check payable to: MHS Class of 1964
Mail Check and Form to:
Oscar del Mazo
P.O. Box 201
Ducktown, TN 37326
You MUST click on the CONTINUE button below to complete registration
rev: 07182019-1