"Sixth Corps to Gettysburg"
2013 Memorial March Registration

Last Name ___________________________________ First/Middle________________________________

Address __________________________________________City ___________________ State ____ Zip ______

Phone H: __________________________ W: __________________ Cell (optional): _____________________

E-mail Address ____________________________________________________ (for registration confirmation)

Emergency Information

Date of Birth ___/_____/____ Medical Problems ____________________________________________________


In Case of Emergency Notify ___________________________________Relationship ______________________

At Phone Number: Day: ________________________________ Night: ___________________________________

We will ask each participant to provide proof of medical coverage or assumption of liability.

Your desired participation level

A. Days and distances (Check the box next to your selection)

  Day One - June 26 -
Ox Hill to Dranesville
(approx. 15 miles)
  Day Two - June 27 -
Dranesville to Edwards Ferry
(approx. 15 miles)
  Day Three - June 28 -
Edwards Ferry to Hyattstown
(approx. 17 miles)
  Day Four - June 29 -
Hyattstown to Taylorsville
(approx. 22miles)
  Day Five - June 30 -
Taylorville to Manchester
(approx. 17 miles)
  Day Six - July 1 -
Day of rest near Manchester
  Day Seven - July 1 (10:30PM) & July 2 - Manchester to Little Round Top (approx. 37 miles)

B. ___ I will be in period Union military uniform, appropriate to June, 1863.

C. ___ I will be in modern clothing.




Complete and current information is available at www.dougdobbs.com.
Please read that info and if you have further questions,
contact Doug Dobbs at
doug@dougdobbs.com or C: (717) 816-2941.
After June 25 I will most likely not check email messages, call the cell number.
Please print & complete this form and bring it with you.

Be aware that space is limited to 35 participants on any given day.
Priority will be given to those in period Union military uniform,
but it's basically first registered, first served.
$13/day is requested to cover our expenses, payable in cash when you show up.
Bring additional cash for incidentals and any extras you may want.