1. REGISTRATION FORM
ALUMNI
NAME First Maiden Last
ADDRESS Street City State Zip Code
CONTACT Home Phone Cell Phone E-mail
PARTICIPANTS
REGISTRATION
NAME Parkway Ballroom Family Picnic T-Shirt
Adult Only Event Indicate size: S, M, AMOUNT
First and Last
L, XL, 1X, 2X, 3X DUE
(please list each guest separately) $50 per EXTRA $10 per $10 per
guest EXTRA guest EXTRA guest
Name of Included Included Included $160
Alumni: Size:
Name of
Guest 1:
Name of
Guest 2:
Name of
Guest 3:
Name of
Guest 4:
You may choose to either email your completed form to HPCAReunion1990@aol.com, or mail in your payment to HPCA c/o 90
rd
CARE OF: Michael Scott Box #254, 1507 E 53 Street Chicago, IL 60615