Alumni Reunion Weekend Registration Form from Boonshoft School of Medicine

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Reunion Weekend Registration Form

Note: Each medical alumnus who registers for reunion will receive a complimentary T-shirt, Class Photo, and Class Memory Book

First Name
Last Name
Class Year
Address
City
State
Zip Code
Daytime Phone
Cell Phone
Email Address
T-Shirt size

Other family members who will be attending:
	Name	Age	Will need a babysitter for Saturday
Spouse		n/a	n/a
Child 1
Child 2
Child 3
Child 4

Would you like to subscribe to the online email directory? Confirmation will be sent via email.
Do you plan on using the complimentary shuttle service for Saturday night's cruise?

Event	# Attending	Cost
Multi-Day Packages
3 Day Package - BEST VALUE. Includes after-hours at the Newport Aquarium, CME Brunch, Riverboat Cruise, and King's Island. Does not include Babysitting or C. M. E. for Kids.		$120 per person

2 Day Package - Includes after-hours at the Newport Aquarium, CME Luncheon and Riverboat Cruise. Does not include Babysitting, C. M. E. for Kids, or King's Island.		$100 per person

Individual Events
Friday, July 18th Newport event		$50 per person
Friday, July 18th Children 12 & under for Newport		$35 per child
Saturday, July 19th C. M. E. Brunch		$10 per person
Saturday, July 19th C. M. E. for kids		$10 per child
Saturday, July 19th Riverboat Cruise		$50 per person
Saturday, July 19th Babysitting	0	$30 per child
Sunday, July 20th King's Island		$25 per person

Credit Card Payment

You may pay your registration fee online with Visa, MasterCard or Discover by checking "Pay Online" below. If you prefer not to pay online, credit card orders may be made by calling (937) 775-2972. Alternatively, you may print this completed form and mail it with your check(s) (made payable to Wright State University) to the following address: Office of Advancement, Boonshoft School of Medicine, Wright State University, 3640 Col. Glenn Highway, Dayton, OH 45435.

Pay Online