Please Complete the Unit Registration Form Below:

(Only ONE Unit Registration should be Completed)
(Each Reenactor should complete an individual Reenactor Registration)
(Reminder: the registration fee is $15 before May 1st and $20 after.)
Questions should be directed to Ed Larry 304-457-3773
(Submit the Registration when Completed)
JUNE 1-4, 2017
Unit:
Contact Position:
Contact First Name:
Contact Last Name:
Address:
City:
State & Zip: 
Phone:
Email:
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Army
Type


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Unit Description:
OPTIONAL Describe the Unit Above. We may use this in a listing of attending units on the website.


Member List:
PLEASE List the Attending Members in the scrolling window Above. Please include Rank and Full Name.