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Harbor Defenses of the Delaware Living History Assoc.
First Name
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Last Name
*
Unit
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Rank/impression
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Email Address
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Contact Phone Number
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Male/ Female
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Male
Female
Age, use other and type in the age
*
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Other
Other
Street Address
*
City
*
State
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Zip
*
Emergency Contact First Name
*
Emergency Contact Last Name
*
Emergency Contact Phone Number
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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
*
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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)
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