Please
send form and payment to:
Gregath Co. Inc., PO BOX 505, Wyandotte, OK 74370.
Name: ___________________________________________________________________________
Address: _________________________________________________________________________
Phone
Number:_______________________________ 
Email: ________________________________
1 Genealogical/Historical OR Lineal Organization (for nametag): ________________________________
Preferred Roommates (optional): _____________________________________________________________________________________________
_____________________________________________________________________________________________
Person who referred me to this retreat (optional): _____________________________________________________________________________________________
______
I am handicapped and have cleared arrangements with
_________________________
(for reservation purposes only)

____ Sending a $75.00 down payment for the below registration:
____ Early Bird Full Retreat @ $160.00 $___________
as space available until May 1, 2013
____ Standard Full Retreat @ $175.00 $___________
as space available until October 1, 2013
____ Day Tripper Session @ $25.00 = $______________
Until
October 1, 2013 - as available
Sessions: ___________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Canceled reservations are eligible for a small portion
refund.

NO
SHIPPING OR HANDLING FEES NEEDED
Page Last Updated:
April 17, 2013