Online Registration Form

Your full name
Your email address
Home Phone
Cell Phone
Select your Bynum-Garig Ancestor	Edna Elmon Thaddeus Ethel Blanche Charles Mary Rebecca Guest
Will you be attending the reunion?	Yes No Maybe (will decide before payment deadline)
If yes, will you require hotel accommodations?	No Yes, Suite, NS Yes, King, NS Yes, 2 Queens, NS Yes, Suite, Smoking Yes, King, Smoking Yes, 2 Queens, Smoking Yes, Other (Explain below)
Other hotel accommodations required
Please indicate the number of attendees by age group (including yourself):
# Adults 18+
# Children 0-4 Years
# Children 5-8 Years
# Children 9-11 Years
# Children 12-14 Years
# Children 15-17 Years
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