subject_line
Harbor Defenses of the Delaware Living History Assoc.
First Name
*
Last Name
*
Unit
*
Rank/impression
*
Email Address
*
Contact Phone Number
*
Male/ Female
*
Male
Female
Age, use other and type in the age
*
🛈
Other
Other
Street Address
*
City
*
State
*
Zip
*
Emergency Contact First Name
*
Emergency Contact Last Name
*
Emergency Contact Phone Number
*
Relationship
*
Spouse
Parent/Guardian
Family Member
Significant other
Other
Other
Days Attending
*
Wednesday
Thursday
Friday
Saturday
Sunday Take Down
Impressions and Artifacts Click all that Apply.
*
Historic Weapons Id will be required
Historic Vehicle please list under Other
Historic Display Please list under Other
Other
Other
CCW/Mil/LEO
*
🛈
CCW
Military
LEO
No
Medical or other conditions.
Vehicle and artifact information
*
🛈
How did you hear about this event
*
previous attendance
website
Facebook
Other
radio
radio
For those paying via check, Make the check out to D G Hattier (FM)
Powered by
Report abuse