Wyoming Registration 2009
July 10 - 12
Mail insurance cover sheet and this form to:
Harry Stephens, 8022 Jefferson Street, Hummelstown, Pa, 17036

Unit Name:         ________________________

Unit Affiliation:   _____Continental Line   _____British Brigade  _____Brigade of the American Revolution

Number of Personnel: _____Muskets/Officers  _____Musick             _____Camp Followers
 
                                     _____Artillery                 _____Cavalry            _____Horses (if different than Cavalry)

Tents:  _____Wedges _____Wall _____ Marquee _____Fly  _____Other

            _________________________Specify "Other" here.

Modern Camping -

Moon Lake Park has a limited number of modern camping sites.
You must make reservations with the Park in advance of the event to insure a space.
Luzerne County Parks Dept., 196 Moon Lake Road, Hunlock Creek, PA 18621 Phone: (570) 477-5467 Fax: (570) 477-2306
Email: moonlake@epix.net

Straw and Hay :
                               Straw and Hay will not be provided unless requested
If you have a requirement for Straw or Hay please indicate how much is needed in the Comments section below
 

Insurance:
note: unit insurance, either through individual unit coverage
or umbrella coverage is required for participation in this event.
   
Please provide the following contact information:

Commander's Name:______________________________

Contact Person:__________________________________

Street Address:_________________________________________________________________

City:_________________ State/Province:_______________Zip/Postal Code:_______________

E-mail:________________________________________

Phone:________________________________________

Comments________________________________________________________________________________

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