114th Aviation Company Reunion 2011

114th Aviation Company
"Knights of the Air"

2011 Reunion Registration
Printable Form

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Listed below are the registration and tour costs for the reunion. Please enter how many people will be participating in each event and total the amount. Send this completed form along with your check made payable to 114th Aviation Company Association if paying by check or money order. Credit Card Payments enter credit card information as required. (Visa or MasterCard Only).

Card Number: ......................................... Expiration Date: ....................

Name on Card: ......................................................................................

Mail Checks to:
Charlie Brown
18 Beaver Lane
Easton, PA 18045
Phone: 610-258-7305

Office Use Only:
Check #: .......................................
CC Payment: ................................
Date Received: .............................

Item	Cost	Number	Amount

* Member Registration Fee ....................................	$40.00	x ............	$ ............
* Spouse/Guest Registration Fee (each) ..............	$30.00	x ............	$ ............
* Children under 17 years ....................................... * Special "Buffet Style" breakfast sign-up............	$10.00 $10.00	x ............ x ...........	$ ............ $ ............
Seniors - Golf at the Bridges Golf Club - 10:30 am Young Whippersnappers........................................ The deadline for registering for the golf outing is Sept. 27th. After that payment must be made at the golf course.	$32.00 $40.00	x ............ x ............	$ ............ $ ............
Lancaster area bus tour – Bird-In-Hand & Intercourse - 8:00 am to 1:00 pm - Includes Dinner at Plain & Fancy Farms - Adults - Transportation included from Hotel ...................... Children (Ages 2-12) ................................................	$65.00 $48.00	x ............ x ............	$ ............ $ ............
Gettysburg visit includes Cyclorama, Museum and Battlefield visit - Includes dinner at Hickory Bridge Farm - 8:00 am to 1:00 pm - Adults Transportation included.......................................... Children (Ages 2-12) ...............................................	$60.00 $50.00	x ............ x ............	$ ............ $ ............
Banquet Dinner per person times total number of dinners - Adult.......................................................... Children (Ages 3-12) ...............................................	$43.00 $17.00	x ............ x ............	$ ............ $ ............
Membership Fee: Now thru 12/31/11 .....................	$20.00	x ............	$ ............
Please make checks payable to 114th Aviation Company Association .............................................		Grand Total:	$ ...............

* Registration fee includes cost for Hospitality suite. ___________________________________________________________

Saturday Night Banquet will be buffet style. See Itinerary for more info on Banquet.	Will attend Banquet	Will not attend Banquet
Member Name: .....................................................................................................	[...............]	[...............]
Spouse Name: ......................................................................................................	[...............]	[...............]
Guest Name: .........................................................................................................	[...............]	[...............]
Guest Name: .........................................................................................................	[...............]	[...............]

Member Name (for name tags) .................................................. Year (s) served: ........................

Spouse Name: ..................................................................................................................................

Guest Name: .....................................................................................................................................

Current Street Address: .................................................................................................................

City, State, Zip Code: ......................................................................................................................

Phone: ................................................... Email: ................................................................................

Emergency Contact: ........................................Phone: ..................................................................

Special Dietary/Disability Needs: .................................................................................................
............................................................................................................................................................

All registration forms and payments must be received by Aug 31, 2011. After that date, all reservations will be on a space available basis. Hotel reservations must be made directly with the Hotel at 877-999-3223 or 800-996-3426. Mention the 114th to obtain the group rate.