RE-ENACTOR'S Registration Form

REGISTRATION FEE OF $5.00 PER PERSON IF PRE-REGISTERED BY 5/15/2015. WALK ON FEE AFTER 5/16/2015 - $8.00 PER PERSON: DO NOT SUBMIT VIA THE LINK BELOW; IT DOES NOT WORK.

MAIL TO: BATTLE OF CYNTHIANA, C/O KEVIN HALL, 612 DUTCH CHAPEL ROAD, CYNTHIANA, KY 41031

PLEASE FILL OUT FORM, PRINT AND SEND VIA USPS WITH PAYMENT BY 5/15/2014 TO BE PRE-REGISTERED:

Name

ADDRESS

CITY, STATE, ZIP

PHONE #:

EMAIL ADDRESS

AFFILIATION:

NAME AND RANK OF GROUP MEMBERS

UNIT PORTRAYAL