Harbor Defenses of the Delaware Living History Association

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 *

Days Attending *

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 * 🛈

Medical or other conditions. 🛈

Vehicle and artifact information * 🛈

How did you hear about this event *

Payment Area. This is via Paypal. Due to our planning requirements, registration after 15 April has a higher fee. We are holding the price at $37.00 * 🛈

Basic Fee

After 15 April 2024