Registration Information (please print)
Please make check/money order payable to and mail registration form to:
Cynthia Fox, 752 Tamara Path, Newport News 23601; Phone 757-263-9044; OR
Myra Corbin, 620 Decatur St., Newport News 23605; Phone 757-435-1755; OR
Denise Waldon, 1633 Wingfield Dr., Hampton 23661; Phone 757-870-6102
(CashOut App No Longer Available)
(Please indicate if you ____"DO NOT" OR _____ "DO" desire to share the below contact information with other classmates.)
Name: _________________________________
(Ladies include your last name in high school)
Address:__________________________________
_________________________________________
Phone number:_____________________________
Cell phone number:__________________________
Email: _____________________________________
Number of Guests:___________________________
Name of Guest(s)__________________________
_________________________________________
Other info:__________________________________
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Registration payment:
Weekend Registration $ 85.00 per person
Saturday Dinner only: $ 60.00 per person
Entire weekend: # of persons_______________
Amount paid $____________________________
Saturday Dinner only: # of persons__________
Amount paid $____________________________
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No T-Shirt or Polo Shirt Orders After August 9th
T-Shirt(s) size(s): (S-1XL - $10 ea) ________________________
T-Shirt(s) size(s): (2XL - 5XL - $12 ea) _____________________
Amount paid: $__________________________________
All Polo Shirts (S-5XL - $12 ea) _________________________
Amount paid: $___________________________________
Total Amount Paid [includes Event and/or Shirt (s)]: ________________________
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