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Form for registering to attend the June 16, 2012 Rebeleer reunion, which will be held from 4PM to 11PM at the Pritchard Community Center.
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EAST HARDIN REBELEER REUNION 2012
Registration Form
Date: June 16, 2012 Location: Pritchard Community Center – 404 S. Mulberry-Elizabethtown
Time: 4:00 p.m. – 11:00 p.m. (Dinner at 6:00 – short program to follow, but please come at 4:00!)
YOUR NAME _____________________________MAIDEN NAME ______________ CLASS OF 19_____
Street Address ______________________________________________________________________
City _________________________________________ Zip Code ______________
Phone Number(___)______________ email address ______________________________________
Years you were a member of the Rebeleers 19___ - 19___ instrument/role ___________________
WE HAVE LOTS OF PLANS! Please take a moment to list 1-5 of your favorite band memories. Be
specific or general… it doesn’t matter! If you need more room, feel free to use the back of this form,
attach another page, or email them to us.
__________________________________________________________________________________
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WE NEED YOUR HELP! If there are any special people/volunteers who gave above and beyond during
your years in the band, would you tell us who they are? Include contact information if you have it.
__________________________________________________________________________________
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____ YES, I have pictures that I will scan and send to: [email protected] (The sooner the better!)
____ YES, I have the following mementos I will bring to share and/or display: __________________
__________________________________________________________________________________
TOTAL NUMBER of PEOPLE ATTENDING ______ ($20.00 per person) Check Total: _____________
Make your check payable to: Rebeleer Reunion.
Send this registration form and your check to: Rebeleer Reunion
c/o Glenda Murphy
725 Freeman Lake Road
Elizabethtown, KY 42701
PLEASE RESPOND BEFORE MAY 1, 2012.
