Living History Weekend Registration

Re-enactor and Sutler Registration Form

Please complete the form below to register for Living History Weekend on Saturday, June 24 and Sunday, June 25 2017

Contact

Your First Name (required)

Your Last Name (required)

Your Address (required)

Your City/Town (required)

Your Province/State (required)

Your Postal Code (required)

Your Phone Number (required)

Your Email (required)

Unit Information

Unit Name (required)

Unit Commander Name (required)

Insurance Company (required)

Policy Number (required)

Time Period

French & Indian WarsJacobite or HanovariansWar of 1812Rebellion of 1837Fenian RaidsAmerican Civil WarWW1WW2Other

Role

Infantry/MiltiaArtilleryCamp FollowerCommand StaffSutlerFirst NationsBoat CrewOther

Family Participants

Please list the names, ages and roles of ALL participants in your family. Note: Individual waivers must be signed upon arrival at event by everyone 18+. Parents or Guardians must sign for participants under 18 years of age.

Artillery

Are you bringing Artillery? NoYes

If yes, what type?

If applicable: I am transporting the unitCannonBoatFly

Accomodations

To be brought by you:
Military Wedge Tent(s)Standard Wall TentWall Tent with Fly FrontBell/Sibley TentOfficers MarqueeNative Lodge, Wigwam or TeepeeI am bunking in others tentageI am daytripping, no tent required

How much space will you require, please remember to include tent ropes in your figures in feet.

If you are daytripping, please specify what days you will be here for:
Saturday OnlySunday OnlyBoth Days

If you are staying for Saturday supper at 5pm, please indicate how many people are eating.

If you will be eating Saturday & Sunday continental breakfast 7-9am, please indicate how many people are eating.

Do you have any special needs, concerns or questions?

Release

I hereby release and forever discharge Backus-Page House Museum, Tyrconnell Heritage Society, and Her Majesty the Queen in right of Ontario as represented by the Minster of Natural Resources its agents and assigns, and their employees and volunteers from any and all actions, causes, claims and demands for damages, loss or injury, howsoever arising, which may hereafter be sustained, by myself, members of my family, our equipment and property and of our organization and waive all rights thereto.

Thank you for registering for Living History Weekend. Should a question arise after submitting your registration you may contact Event Coordinator Beth Goldsworthy at 519-207-2224 or email at kingsco1812@hotmail.com



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