Re-enactor Registration Form

Registration Deadline: May 3, 2010

The City of Hamilton - Hamilton Civic Museums is collecting the information on this form in order to fulfill your registration for the Re-enactment of the Battle of Stoney Creek event. Your personal information will only be used and/or disclosed for the purposes for which we are obtaining your consent, or as permitted or required by law. For more information about how your personal information is collected, stored and used, read the City of Hamilton's Privacy Agreement.

All fields are required to properly process your registration.  Registration is for individuals only. All participants over the age of 18 must register individually.

First name:
Last name:
Address:
City:
Province/State:	Select one Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Alabama Arkansas Arizona California Colorado Connecticut District Of Columbia Delaware Florida Georgia Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Postal/Zip:
Telephone #:	( )
Email:
We value your privacy. Your email address will only be used by the Hamilton Civic Museums to communicate with you regarding the Re-enactment event. We will not share your email address without your permission. If you do not want to receive email from the Hamilton Civic Museums regarding the Re-enactment event, leave the space above blank.
Vehicle Licence #:
Make of Vehicle:
There is no parking on site.  Do you require special provisions for parking?	Yes No
Unit Portrayed:
Rank:
Unit Insurance Company or Personal Insurance Policy No.:
Number of people attending (including yourself). Enter 0 for groups not attending.
Soldiers:
Camp Followers:
Children:
Do you require a fire pit tray? (digging of fire pits is not allowed):	Yes No
Indicate which meals you will require: (we can not provide your meals unless you pre-register)	Saturday Breakfast Sunday Breakfast Both (Sat. and Sun)
Tent Style:	Authentic Modern encampment Not bringing a tent
Size (including ropes, if applicable):
Artillery:
Size:
Quantity:
Do you wish to blanket trade during the weekend?	Yes No
Number of blankets:	($10 per day, per blanket)
Please send blanket trading payment by cheque, payable to Battlefield House Museum, or we can not guarantee registration.
HISTORY IN ACTION DAY - Friday, June 4, 2010 (9:30 am - 2:30 pm)
Are you available to participate at History in Action Day?	Yes No
If yes, what will you demonstrate?