"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 DranesvilleDay Two - June 27 -
Dranesville to Edwards FerryDay Three - June 28 -
Edwards Ferry to HyattstownDay Four - June 29 -
Hyattstown to TaylorsvilleDay Five - June 30 -
Taylorville to ManchesterDay Six - July 1 -
Day of rest near ManchesterDay 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. |
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| 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. |
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