REGISTRATION FORM
SKIRMISH AT LUXAPALILA
FRIDAY, SATURDAY, SUNDAY
SEPTEMBER 26th, 27th, 28th 2008
IVAN K. HILL PARK
WINFIELD, ALABAMA

SPONSORED BY: 3RD SGT. WILLIAM J. MARTIN CAMP 2004-SONS OF CONFEDERATE VETERANS
HOSTED BY: SELDEN'S BATTERY RE-ENACTORS, ALABAMA DIVISION

BY SUBMITTING THE FORM BELOW I AGREE TO SUBMIT AND ADHERE TO THE EVENT POLICIES, RULE AND GUIDLINES SET FORTH BY THE ALABAMA DIVISION RE-ENACTORS, THE EVENT STAFF, AND COORDINATORS.

NAME:________________________________ AGE:____ PHONE: Day:_______________
Night:_______________
ADDRESS:__________________________________________ Cell:_______________

CITY:_______________________ STATE:______ ZIP CODE:______________

E-MAIL:__________________________ LOCAL UNIT/MESS:_______________________

MEDICAL CONDITIONS:_____________________________________________________

EVERYONE MUST submit a Registration form in order to participate in this event. Early registration is encouraged by not mandatory. The registration
fee is $5.00. Meals will be served to registered participants Saturday evening. Make checks or money orders payable to: "Skirmish at Luxapalila". Send
registration form and fees to:

Randy Brown-Commander
3rd Sgt. W.J. Martin Camp
325 US Highway 43
Winfield, AL 35594

!!! POWDER BOUNTY!!!
$125.00 POWDER BOUNTY TO FIRST EIGHT (8) REGISTERED ARTILLARY PIECES (3" BORE OR LARGER)
1 LB. POWDER RATION TO FIRST 100 REGISTERED INFANTRY OR DISMOUNTED CAVALRY

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CLICK HERE FOR GUIDELINES

randy215@centurytel.net