St.

Petersburg,
Florida

2016 Ceaser-White Family Reunion Registration Form

Family Reunion Fees: When considering the fees, please keep in mind we have three meals planned and
will be utilizing a facility where the reunion will be held.
Adult $65 (13yrs & up) / Youth $40.00 (6yrs - 12yrs) / Child $10.00 (3yrs - 5yrs)
Feel free to make payments at any time towards your familys reunion fees until the final due date of
June 22, 2016. Please note, no money will be accepted at the reunion due to all the final arrangements
for the reunion will have been made by this time.
Name

Age

Adult/Youth/Child

Total Enclosed

Amount Paid
$

Address: ____________________________ City ________________ State ____ Zip _________

Phone: (____)_______________ Email: ______________________________________
**** Payment Methods ****
Payments: Payments can be made via the following methods. Please contact us if you have any questions
using these services.
Checks: Checks can be made out to Ceaser-White2016 Family Reunion (GTE Financial Credit Union)
PayPal: Payments can be sent to ceaserwhite2016@gmail.com via PayPal.com
PopMoney: Payments can be sent to ceaserwhite2016@gmail.com via PopMoney.com
Are you or a family member celebrating a Birthday/Anniversary? If yes, please list below.
____________________________________________________ Actual Date: ________
____________________________________________________ Actual Date: ________

Would you or a family member like to be on the program for entertainment? If yes, provide details.
_______________________________________________________________________________
__________________________________________ Time needed: ___________
Would you or a family member like to volunteer at the reunion? If so, list name(s) below.
Name: _____________________________________ Phone #______________________
Name: _____________________________________ Phone #______________________
**** Tee Shirts ****
Tee Shirts: Details for the tee shirts are still being worked. We will be providing this information with the
next communication.

Please mail all reunion correspondence to:

Jennie M. Heath
637 52nd Avenue South
St. Petersburg, FL 33705-4955
Home: (727)864-3999
Cell (727)560-3832
Email: jenniemheath@gmail.com