BERNBECK COUSINS REUNION

                              July 18 - 20, 2003
                       Ramada Inn, Norfolk, Nebraska, USA


We will be there!        (circle one please)                YES    or     NO

We have reservations at: Ramada Inn     ___

                         Name of Motel  ____________________________

                         Staying with family in area  ______________

We will arrive by        CAR    Time expected to arrive  ___________

                         PLANE  Flight Name/No.  ____________  Time: ________

                         Renting a car?  ___________

I would like to take Con up on offer of being picked up via van/car on
Friday and returned to the airport in Omaha on Monday.
                                                             YES           NO

*we are coordinating shuttle trips for individuals who fly in*


Registration: $10 per adult to confirm registration.  There may be an
additional fee upon registration at the Reunion to cover additional costs.

Volunteers:                   MC, Skits or Musicals

For name tags and head count, please include everyone that will be in
attendance.

      Name                Address
  Relationship       age (if under 18)

_________________  _____________________

_________________  _____________________

_________________  _____________________

_________________  _____________________

_________________  _____________________


Please return this form as soon as possible.  This information will be used to
order food & beverages, as well as prepare the meeting area.


This Reservation is from: _______________________________________(your name)

Enclosed is $10.00 per adult.

Please mail to:   Judy Baesler
                  859 SE 31st Court
                  Hillsboro, Oregon  97123