UNIT NAME ______________________________________________

Individual or Unit Contact Person ______________________________________________

 

Mailing Address _____________________________________________________________

                                 _____________________________________________________________

                                 _____________________________________________________________

 

Home Tel. Number ____________________         E-mail _________________________________________

 

Number of Participants               Infantry:    US _______                  CS ________

                                                            Artillery:   US _______                  CS ________

                                                            Civilian:    US _______                  CS ________

 

Signature _______________________________________________  Date ___________________________

 

Clearly print ALL PARTICIPANT NAMES on reverse.  Identify each individual by military rank, as a civilian or minor (12 and under – no charge). Officers above the rank of Captain must be approved by the US or CS commanders.

 

EARLY REGISTRATION: $5.00                                NORMAL REGISTRATION: $8.00

Postmarked by October 15, 2010                               Postmarked by December 1, 2010

 

________ x $5.00 = ___________                               _________ x $8.00 = ____________

 

Make checks payable to:  GBBA

All funds rec’d. will be used for the restoration of the Goldsborough Bridge battlefield.