PO BOX 77384 Washington, DC (NE) 20013
Main Contact Name (First and Last) Address Line 1 Address Line 2 City and State
Zip Code
E-mail Address
SECTION 1: Registration Type Adult Individual Registration — $35.00
QUANTITY
This option entitles the registrant to ONE (1) admission to all events and food (3 meals including: Meet & Greet, Birthday Gala Soul Food Fest, and Family Fellowship Brunch).
Adult Couple’s Registration — $50.00 This option entitles the married couple to TWO (2) admissions to all events and food (3 meals including: Meet & Greet, Birthday Gala Soul Food Fest, and Family Fellowship Brunch).
Child’s Registration — $10.00 (ages 6-18) When coupled with a qualifying adult registration, this option entitles the child to ONE (1) admission to all events and food (3 meals including: Meet & Greet, Birthday Gala Soul Food Fest, and Family Fellowship Brunch). Note: Children 5 and under are free!
SECTION 2: Additional Attendees
List spouse, children or other attendees names who are also registering through this form:
Other Attendee 1
CHILD
OTHER ADULT
Other Attendee 4
CHILD
OTHER ADULT
Other Attendee 2
CHILD
OTHER ADULT
Other Attendee 5
CHILD
OTHER ADULT
Other Attendee 3
CHILD
OTHER ADULT
Other Attendee 6
CHILD
OTHER ADULT
SPOUSE
TOTAL 1:
REGISTRATION Total
TOTAL REGISTRATION MONIES ENCLOSED
TOTAL # OF ATTENDEES