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
CONTINUED
T
he year was 1922, and it was a very different time. It was an age before computers, cell phones, or President Obama. It was the year that insulin was discovered, the first female US Senator was elected, and gas costed a mere 25 cents per gallon. In that same year was born to Toney & Nellie (Pratt) Lilly, a son they named Thomas. As the baby boy, Jim, as he is affectionately known, was entrusted to do the “manly chores”. The origin of his nickname remains a mystery, but he believes it came from another young boy’s inability to pronounce his name. Regardless of the origin, the name stuck and became the name by which he was and is commonly referred. Jim and his late wife, Fannie, raised their children in the Heights of Peoria, Illinois, where he has resided for almost 60 years. He has become a pillar of that community, a respected of gentleman, and a dear friend and father-figure to those near and far. This year, Thomas Lilly will celebrate his Ninetieth Birthday! Whether you have come to know him as Uncle Jim, Mr. Lilly, cousin, friend, or church member, the time has come for us to observe this milestone birthday and, we’re excited to do it in a very big way! Please consider sharing your Father’s Day Weekend with us, June 15-17, 2012, as we observe Thomas Lilly’s 90th Birthday Gala and Family & Friends Homecoming. We have planned a weekend full of fun, food, and fellowship! See itinerary for more details. It’s going to be an awesome experience. We look forward to seeing you in June!
FRIDAY, JUNE 15, 2012 Registration and T-Shirt Pickup 5:00 pm – 10:00 pm
SECTION 3: Family & Friends T-Shirts
Meet and Greet with hors d’oeuvres
T-shirts are available from size Small to XXXL for the cost of $10 (small – XL) and $12 (XXL and XXXL). Check the appropriate box and list the quatity of shirts you wish to order.
6:00 – 10:00 pm
SATURDAY, JUNE 16, 2012 Registration and T-Shirt Pickup 10:00 am – 1:00 pm
Harlem Rennaisance-Themed Birthday Celebration Gala with Soul Food Feast 5:00 pm KNIGHTS OF COLUMBUS 7403 North Radnor Road • Peoria, IL
SUNDAY, JUNE 17, 2012 Family Worship Service & Brunch Service at 10:00 am; Brunch Immediately following WARD CHAPEL A.M.E. CHURCH 511 North Richard Allen Drive • Peoria, IL
SpringHill Suites by Marriott Peoria 2701 West Lake Avenue, Peoria, IL 61615 Phone 309-681-2700 Fax 309-681-2701
Small $10.00
Room Block: June 15, 2012 – June 17, 2012 Cost: $99.00 plus tax
Medium $10.00
XLarge $10.00 QUANTITY
XXLarge $12.00 QUANTITY
QUANTITY
XXXLarge $12.00
Large $10.00
Reservations can be made by calling us toll-free at 888-287-9400, ask for “Lilly Reunion”
QUANTITY
Deposit Due Date: Deposit must be received by: 05/15/2012
QUANTITY
QUANTITY
TOTAL TSHIRT MONIES ENCLOSED
TOTAL 2:
TOTAL # OF TSHIRTS
TSHIRT ORDER Total
Reservation Method: Call Hotel Direct for Reservations Check in: 3pm • Check out: 12:00 noon
SECTION 4: Grand Total GRAND Total:
Birthday Celebration Gala Have you seen the movie Red Tails? No, it wasn’t based on Mr. Lilly, but he fought and served his country during that time. To honor his birthday and celebrate the culture surrounding his youth, we are extending the option for you to wear period costumes inspired by the Harlem Renaissance and the Roaring Twenties. Visit www.thomaslilly.org for examples of what we have in mind. Keep in mind, Twenties’ attire is optional, but we ask that you wear semi-formal attire to the Birthday Gala, if you are not dressed in costumes. Family Worship Service Ward Chapel AME Church is a historic religious entity in the heart of South Peoria, yet they embrace a contemporary and progressive worship style. On Father’s day, we encourage everyone to wear their Thomas Lilly t-shirts.
TOTAL 1: REGISTRATION
TOTAL 2: TSHIRT ORDER
GRAND TOTAL
Please add your totals 1 & 2 to calculate the total amount of your registration.
SECTION 5: Method of Payment Cash
Check
Money Order
Payalble to Lilly Family Reunion
CHECK HERE IF YOU PLAN TO STAY IN THE SPRINGHILL SUITES DURING THE EVENT.
RETURN THIS FORM TO:
Lilly Family Family & Friend’s Homecoming c/o Bonita G. Lilly PO BOX 77384 • Washington, DC (NE) 20013 PAYMENT OPTIONS. We will except payments in the form of cash, checks, money orders (payble to Lilly Family Reunion), debit or credit cards (via www.thomaslilly.org). Refunds. No refunds will be given for any level of payment. Returned Checks. The fees for returned checks will be the sole responsibility of the issuer. If you write a check that is returned for insufficient funds, you will be responsible for the amount of the check plus a $40 returned check and administrative fee. Further, we will no longer accept checks from you.
DEADLINES: Please be reminded of the following deadlines and plan accordingly • Hotel Registration Deadline: Tuesday, May 15, 2012. • Event Registration Deadline: Friday, May 18, 2012.