NAME : ___________________________________________________________________________________________________

ADDRESS: ________________________________________________________________________________________________

_________________________________________________________________________________________________________

PHONE: _____________________ MOBILE: ________________________ EMAIL : ____________________________________

NAME(S) OF YOUR GUESTS: ______________________________________________________________________________

BANQUET MEAL SELECTIONS: BEEF _____________________ CHICKEN _________________ VEGETARIAN _________

PLEASE LIST ANY SPECIAL NEEDS/REQUESTS: ____________________________________________________________

IN CASE OF EMERGENCY, NOTIFY: _______________________________________________________________________

DATE ACTIVITY # PERSONS CHARGE ITEM TOTAL

REGISTRATION FEE (Required for each Attendee) X $30.00 =

Wed 6/23 /10 Early Bird Luncheon X $17.00 =

Wed 6/23 /10 Reception Dinner @ SUBVETS X $20.00 =

Thu 6/24/10 “Bottom Gun” Pisto l Shoo t X $25.00 =

Thu 6/24/10 TOURS OF SSN 690 * No Charge

Thu 6/24/10 Banquet Dinner X $65.00 =

Fri 6/25 /10 DECOMMISSIONING * No Charge

Fri 6/25 /10 NAVY RECEPTION * No Charge

Fri 6/25 /10 Casino Night – Visit one o f th e area’s larges t att ract ions w ith sh ipmates. No Charge

Sat 6/26/10 Go lf Tournament (9 Holes) * X $25.00 =

Sat 6/26/10 Picnic with Curren t Philly Crew * X $15.00 =

Sat 6/26/10 Clos ing Buffet Dinner X $45.00 =

Sun 6/27 /10 Farewel l Breakfas t X $17.00 =

USS Philadelph ia Sailor’s Association Dues (Op tional): ? $15 ? $20 ? $25 ? Project Donation $____

PAYMENT IS DUE NO LATER THAN MAY 23, 2010 TOTAL ENCLOSED

*PER NAVY REQUIREMENTS & SUBJECT TO CHANGE. ADDITIONAL INFORMATION IS REQUIRED. For Golf, P icnic, Tours, De commissi oning, and Recepti on: Submit Fu ll Name, Citizenship, and Date of Bir th for EACH person be low.

PLEASE SEND PAYMENTS TO THE FOLLOWING ADDRESS AND MADE PAYABLE TO:

For A ttendees to events on SubBase Include:

FULL NAME Citizenship Birth Date

The Reunion BRAT 50721 State Hwy 410 E

Greenwater, WA 98022 Phone: (360)663-2521

Confirmation of Registration and Itinerary wil l be sen t out by June 5, 2010 . $20 per per son cancellat ion fee wi ll apply to all cancellat ions

received within 30 days of the event. Cancel lation s received wi thin 10 days of the event will be non- refundab le. Call the Ramada Mystic

Hotel a t 860-536-4281 no later than May 20, 2010 to make your hotel reservations at group pricing. Hotel policy is tha t

cancella tions a fter May 20 wil l be charged full cost of reservation. Be sure to mention you are with th e USS Phi ladelphia Reunion to

receive your group rate of $69/n ight for June 23/24, $109/night fo r June 25/26, p lus tax. The $69/night price is av ailable 3 days prior to and 3 days after the event should you choose to extend your stay.