ACTIVITY REGISTRATION FORM

            Listed below are all registration, tour, and meal costs for the reunion activities scheduled.  Please enter how many people will be participating in each activity and total the amount.  Send that amount payable to Potomac Chapter, 114^th Aviation Company Association in the form of check or money order (credit cards will be accepted also).  No telephone reservations will be accepted, however, you may fax your reservation if you are using a credit card.  Your cancelled check or credit card charge will serve as your confirmation.  All registration forms and payments must be received by mail on or before June 27, 2003.  After that date, reservations will be accepted on a space available basis.  You must make your hotel reservations direct with the Doubletree Hotel – 703-416-4100.  We suggest you make a copy of this form before mailing. 

 

Send this form to:     Potomac Chapter                                           Or Fax to:       703-916-9111

OFFICE USE ONLY Check # __________      Date Rec’d _____________ Inputted __________      Nametag Completed _____

                                    114^th Aviation Co. Assn.

                                    6715 Little River Turnpike, Suite 202

                                    Annandale, VA 22003

 

       

 Cut off Date 6-27-03

TOURS/TRIPS/EVENTS*	COSTS	Number of Persons	Total
7/31 Thursday: Golf Tournament	$75.00		$
7/31 Thursday: Potomac Mills Shopping Trip	$14.00		$
8/01 Friday:  White House/Capital Buildings Tour**	$20.00		$
8/01 Friday:  Memorial Service for George J. Young	$14.00		$
8/02 Saturday:  City Tour	$26.00		$
8/02 Saturday:  Vietnam Wall Memorial Service	$14.00		$
8/03 Sunday:  National Cathedral Services	$14.00		$
MEALS 8/02 Saturday: Dinner Buffet	$26.00		$
8/03 Sunday: Banquet (Please select your entree)            Prime Rib of Beef	$35.00		$
Chicken Piccata	$35.00		$
Reunion Registration	$30.00		$
Total Amount Payable to Potomac Chapter 114th Aviation Co. Assn.			$

*Assignment to Tours is made by First Come Basis

**Photo ID is required for the White House Tour

 

Please complete for all scheduled for the White House Tour

Full Name	Social Security Number	Birth Date

 

Disability/Dietary Restrictions:_____________________________________________________________

Are you confined to a wheelchair? r Yes  r  No

Emergency Contact: ___________________________________ Phone (_____) ____________________

r      I wish to volunteer to hold a Memorial Candle at Saturday Night Memorial Service

r      I wish to volunteer to help sell the Cook Book and History Book at the reunion

 

Name: _______________________________Spouse: _________________________________________

Address: ___________________________________City____________________St______ZIP_________

Check/Money Order Enclosed r or Please Charge my Credit Card r MC r VISA r AMEX

Name on Card: ___________________________ Card # ________________________ Exp. Date: _____

 

Please note Cancellation and refund policy on Tour Description Information