2019 Anthony-Ellison Registration Form
www.anthonyellisonfamilyreunion.com
 
*** This registration form (one for each attendee) and all registration fees must be paid in full for each person attending the Reunion by May 12, 2019 ***
 
Family Name: ___________________________________________________ 
 
Address: _______________________________________________________

City / State & Zip: ________________________________________________

Phone #: ___________________   E-mail: ____________________________
 
2019 Non- Refundable Anthony-Ellison Family Reunion Fees by Ages

Ages 0-2: Free #: ____ (must pay for T-shirt only) if needed
 
Ages 3-4 years:  $20.00 each     #: ______          Amount: $______________
 
Ages 5-10 years: $40.00 each     #:_______        Amount: $______________
 
Ages 11-12:  $ 60.00 each     #: ______          Amount: $______________
 
Children: 13+and Adults:  $99.00 each    #: ________          Amount: $_____________


T-Shirt(s) $15.00 Adults & Youth, $12.00 Child #:_________    Amount: $____________

Total Number in party:______                      Total Amount:  $ ____________     
 
Option 1: Click here to Pay by PayPal (PayPal ME) https://www.paypal.me/FamilyReunionFees
 
  • To pay by Credit/Debit Card, Click the " PayPal Me " link above
  • Wait for the Send Money to “Jimmie” web page to appear, and
  • Then enter the "Dollar Amount" you wish to pay and send as family and friends. Click Next.
  • Enter your Email and Password
  • Then click Log in and follow the instructions
  • You will have to link your bank account to PayPal in order to avoid paying the 2.9 processing fees with a credit or debit card.
  • Please copy and paste this form or list the name(s), address, phone, age, and email of the family member(s) for whom you are submitting payment in the "note" section of the PayPal payment form.
  • Send a copy of PayPal payments Receipts and this Registration Form to jimw4469@hotmail.com.
 
Option 2: To Pay by Cashier Check or Money Order via Mail
 
Send this Form and your Payment To: 
Jimmie Williams
P.O. Box 951566
Lake Mary, FL 32795-1566
 
Please be sure to make your Cashier Check or Money Order out to "Jimmie Williams" (not Anthony-Ellison Family Reunion)
 
Click to Print Form/clients/f/ff/ff850d76676c1858bf5e443b7a907d3b/File/2019%20Reunion%20Registration%20Form(1).pdf