Please Complete the Registration Form Below:

(Submit the Registration when Completed)
JUNE 1-4, 2017
PAID PRE-REGISTRATION FEE OVER AGE 12:
RECEIVED BEFORE MAY 1, 2017 $15.00
RECEIVED AFTER MAY 1, 2017/WALK-ONS $20.00
Rank:
First Name:
Last Name:
Unit:
Address:
City:
State & Zip: 
Phone:
Email:

InfantryYes  No  
ArtilleryYes  No  
Dismounted CavalryYes  No  
USYes  No  
CSYes  No  
CivilianYes  No  

List the Number of Tents
A Frame:
Wall:
Dog:
Sibley:
Payment Amount:
Payment Method:
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Specials Needs:
SPECIAL NEEDS OR QUESTIONS, PLEASE CALL Ed Larry 304-457-3773