Dinner Dance Registration - Westhampton Beach Class of '77!

Reunion Dinner Dance Registration

Saturday Evening, 6:00pm - 11:00pm
Location:Eric and Bonnie (Busking) Wootten's,
107 Oneck Lane, Westhampton Beach

Time: 6:00 pm
Will you be attending the dinner/dance?*

I will be there! I'm sorry, but I cannot make it
Your Name*
First Name Last Name
Phone/cell number*
- Area Code Phone Number
Guest / spouse
First Name Last Name
Your E-Mail
Please select number of guest attending
1 guest attending dinner $55.00 USD
2 guest attending dinner $110.00 USD
3 guest attending dinner $165.00 USD
4 guest attending dinner $220.00 USD
Please print this form and mail appropriate payment to:

   Lynne Cuthbert Jones

   3 Farm Lane

   Westhampton, NY 11977

Or pay via Paypal

(use Paypal button on next page after you hit "submit")
Should be Empty:

Saturday Evening, Class of 77 only