Date:	_______________________________________________________________________
Name:	___________________			________________________________					____________
	Last			First					MI
Address:	_______________________________________________________________________
City:	__________________________			State:	______	Zip Code:		___________________
Phone:          (H)	___________________	(C)	________________			(W)	___________________________
Email:	_________________________________________________________________________

 
 
REGISTRATION (Three convenient options to register):
 
      1.        Online: http://smartfamily.eventbrite.com (Please note Eventbrite will charge a service and payment processing fee upon checkout)
  
     2.        Email your registration form (and use Zelle or CashApp to make  payments).      3.        Mail:  Registrations should be postmarked by 6/10/21.                                   Registration price covers all reunion events.
 
Make checks or money orders payable to:
Karen Cooper
1385 Nixon Chapel Road, Springfield, GA 31329

A $30.00 fee will be assessed for all NSF items and those registrations will not be processed.
 
 
REGISTRATION PRICES (includes one reunion Tee-Shirt per registration):
 
*Important Note: All payments, including installment payments, cannot be refunded, but they can be transferred.

	Select Tee-Shirt Size					Quantity	Cost	Total
Adult Registration	□ S   □  M  □ L   □ XL   □ 1X   □ 2X  □ 3X					__________	$ 130.00	$__________
10 – 3 yr. olds  Registration	□ S   □  M  □ L   □ XL   □ 1X   □ 2X  □ 3X					__________	$ 70.00	$___________
2 and under Registration	□ S   □  M  □ L     (Child Sizes)					__________	$ 25.00	$___________
Individual Event
Saturday
Banquet-only						@	$50.00
Ordering Additional Reunion Tee-Shirts?
Adult Sizes  (S – XL)	□ S   □ M  □ L   □ XL					__________	$ 12.00	$___________
Large Adult Sizes (1X – 3X)	□ 1X   □ 2X  □ 3X					__________	$ 13.00	$___________
Child Sizes (S – L)	□ S   □  M  □ L					__________	$ 12.00	$___________
	Total amount enclosed:							$___________
Vegetarian Meal Required?		YES	□	Food Allergies:	_________________________________