"Sixth Corps to Gettysburg" March Registration

Last Name ____________________________________________ First/Middle_______________________________________

Address _____________________________________________________City ___________________ State ____ Zip ___________

Phone H: _____________________________________ W: _________________________ Cell (optional): _____________________

E-mail Address ____________________________________________________

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 -
Fairfax to Dranesville
  Day Two - June 27 -
Dranesville to Edwards Ferry
  Day Three - June 28 -
Edwards Ferry to Hyattstown
  Day Four - June 29 -
Hyattstown to Taylorsville
  Day Five - June 30 -
Taylorville to Manchester
  Day Six - July 1 -
Day of rest near Manchester
  Day Seven - July 1 (10:30PM) & July 2 - Manchester to Little Round Top

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 (717) 816-2941. After June 25 I will check messages more infrequently.
Since we're now past the mail in registration date,
please print & complete this form then 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.
$5/day is requested to cover our expenses. Bring cash for incidentals.