Please complete the following registration form and return it as soon as possible. If you should need to cancel, your money will be refunded in full. Fee for the reunion is $100.00 for each veteran or person attending. This includes all food, drinks, bus service, and all activities at the reunion during the two-day event. This down not include airfare or hotel fees.

NAME: _____________________________________________________________

STREET ADDRESS: ___________________________________________________

CITY: ______________________ STATE: __________ ZIP: __________

PHONE: ____________________ EMAIL: _____________________________

ATTENDING GUEST NAME: ____________________________________________

RELATIONSHIP TO VETERAN: _________________________________________

(Please check one)
I'll be riding the bus from the Casino Aztar _____ I'll be driving from the Casion Aztar _____

I'll be driving from the Hometown Inn _____

Handicap: No _____ Yes _____ Wheelchair _____ Other _______________________

Would you like to tour the LST in Evansville? _____

Dates at Camp Breckinridge (approximately): From _______________ To _______________

Division: ___________________ Company: ___________________

Infantry: ___________________

Your Commanding Officer: _________________________________________