Registration Form

60's Blast from the Past - 40th Birthday of Riverdale
May 21, 2005 - Saturday - Registration Form
If you are not in a yearbook, please send me a "Then Picture" to put on your name tag.

First Name
Last Name
Address
City
Province/Country
Postal Code

Name at Grad
Year of Graduation

Email Address
Phone Number

Are you attending the Reunion?
Yes
No
Undecided
Are you bringing your spouse or a guest?
Yes
No
Undecided

Are you "married to" or "coming with" a fellow alumni?
Please only check yes if alumni is coming with you. Please check one of the following:

Yes - Please add full name of Alumni
           Name at Grad Year of Grad
No - This is the name of my Guest/Spouse
              (non alumni)                 No - This registration is just for me

Do you want your email address added to the Registration List online?
Yes
No
Do you want your phone number added to the Registration List online?
Yes
No

Administrative Purposes Only - Payment Info

Cheque Number

Date of Payment

Amount of Payment

$60 per ticket (person) - $30 Dance only (8PM to 1AM) No Meal
and send printout with a cheque payable to Riverdale 60's Reunion and mail to:

Riverdale 60's Reunion
c/o Beverley McLaughlin
223 Scenic Way NW
Calgary, Alberta T3L 1B6

Please add comments below:

Please proofread & before hitting the"Send" button below. Thank you.

First Name Last Name Address	City Province/Country Postal Code
Name at Grad Year of Graduation	Email Address Phone Number
Are you attending the Reunion? Yes No Undecided	Are you bringing your spouse or a guest? Yes No Undecided
Are you "married to" or "coming with" a fellow alumni? Please only check yes if alumni is coming with you. Please check one of the following: Yes - Please add full name of Alumni Name at Grad Year of Grad No - This is the name of my Guest/Spouse (non alumni) No - This registration is just for me
Do you want your email address added to the Registration List online? Yes No	Do you want your phone number added to the Registration List online? Yes No