2026 Cumberlander Registration Form
Location: St. Louis, MO
Name
*
First Name
Last Name
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
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Gabon
The Gambia
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Greece
Greenland
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Mayotte
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Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
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Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
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Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
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Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
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Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
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Singapore
Slovakia
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Solomon Islands
Somalia
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South Africa
South Ossetia
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Sri Lanka
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eSwatini
Sweden
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Syria
Taiwan
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Tanzania
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Vanuatu
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Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Cumberlander Clan
*
Alonza
Fannie
Ben
Henry
Charlie
Neppie
Clarence
Robert
Emma
Ruben
Senior(s) Name (85yrs and up)
Adult(s) Name (18-84yrs)
Young Adult(s) Name (13-17yrs)
Child(ren) Name (5-12yrs)
Child(ren) Name (4yrs and under)
Calculation Sheet
*
Categories:
All
All
Reunion Fees
T-Shirts
Scholarship Donation
prev
next
( X )
Reunion Fees
Seniors (85yrs and up)
$100.00
$
100.00
Quantity
0
1
2
3
4
5
6
7
8
9
10
Adults (18-84yrs)
$200.00
$
200.00
Quantity
0
1
2
3
4
5
6
7
8
9
10
Teenagers (12-17yrs)
$125.00
$
125.00
Quantity
0
1
2
3
4
5
6
7
8
9
10
Children (5-11yrs)
$100.00
$
100.00
Quantity
0
1
2
3
4
5
6
7
8
9
10
Children (4yrs and under)
Free
$
Free
Quantity
0
1
2
3
4
5
6
7
8
9
10
T-Shirts
T-Shirts
$15.00
$
15.00
Size
Quantity
Price
Youth XS
0
1
2
3
4
5
6
7
8
9
10
$15.00
$
15.00
Youth S
0
1
2
3
4
5
6
7
8
9
10
$15.00
$
15.00
Youth M
0
1
2
3
4
5
6
7
8
9
10
$15.00
$
15.00
Youth L
0
1
2
3
4
5
6
7
8
9
10
$15.00
$
15.00
Youth XL
0
1
2
3
4
5
6
7
8
9
10
$15.00
$
15.00
Adult S
0
1
2
3
4
5
6
7
8
9
10
$15.00
$
15.00
Adult M
0
1
2
3
4
5
6
7
8
9
10
$15.00
$
15.00
Adult L
0
1
2
3
4
5
6
7
8
9
10
$15.00
$
15.00
Adult XL
0
1
2
3
4
5
6
7
8
9
10
$15.00
$
15.00
Adult 2XL
0
1
2
3
4
5
6
7
8
9
10
$15.00
$
15.00
Adult 3XL
0
1
2
3
4
5
6
7
8
9
10
$15.00
$
15.00
Adult 4XL
0
1
2
3
4
5
6
7
8
9
10
$15.00
$
15.00
Adult 5XL
0
1
2
3
4
5
6
7
8
9
10
$15.00
$
15.00
Scholarship Donation
Scholarship Donation - minimum
$1.00
$
1.00
Donation Amount
Subtotal
$0.00
$
0.00
Tax
$0.00
$
0.00
Total
$0.00
$
0.00
Form of Payment
*
Check - payable to Sasia Roper
Memo: Cumberlander Family Reunion 2026
Zelle - Sasia Roper 618-791-4835
Cash App: $SasiaRoper
Are you interested in participating in the golf outing?
*
Yes
No
If yes, how many will be attending the golf outing?
Provide a number of attendees
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