Early Bird Registration

This form is for early registration- All participants must check in upon arrival and sign waiver form.

 Registration  $7 per reenactor or $10 at event site

(no charge for any female or child in period dress)

Unit Name:__________________________________________________________

Commanding Officer (including rank):___________________________________

Contact Person:_______________________________________________________

Phone Number:_______________________________________________________

E-Mail:______________________________________________________________

Address:_____________________________________________________________

Number of Soldiers Attending:__________________________________________

Number of Family Members Participating (period dress):___________________

Please List Names of All Participants in Group:

______________________________________

_____________________________________

______________________________________

______________________________________

______________________________________

Release, Waiver and Assumption of Risk

I, the undersigned hereby acknowledge that participation in historical reenactments of Civil War battles, demonstrations and camp life exposes me to inherent risks which can Not be avoided. I, therefore, agree that I will take steps required of me to insure my safety and the safety of others and in consideration of my participation in the REENACTMENT of THE BATTLE OF ISLAND #10, FEBRUARY 15,16,AND 17, 2008, agree to assume the risks inherent in this particular activity and agree to hold harmless all persons and groups in charge of and coordinating this event.

Signature:___________________________________________________Date:__________________

 (Under Eighteen Guardian Must Sign):________________________________________________

Everyone must fill out waiver and registration and send in with money to:

Reelfoot Lake Tourism Council 4575 State Rt. 21 E. Tiptonville, TN. 38079

No Alcoholic Beverages Allowed in the State Park

All Horses on State Park Must Show Proof of Coggins Vaccination Shots