Membershipform

Membership form

Note: Minimum age requirement for the group is 16 years of age.

Please fill in the following information.

Name:______________________________________________________________

Address:____________________________________________________________

City/State/Zip:_______________________________________________________

Phone: Day:______________________ Night: _________________

Email address:_______________________________________________________

Re-enactment unit(s) if associated with:

___________________________________________________________________

Any other Family members under 16, who will be joining this group along with you :

Name:_________________________________________ Age:_________________

Please Return to:

Ms. Heather Blair Willis

121-B Ridge Avenue

Cherryville, NC 28021