ON THE FARM -Registration Form

June 14-15, 2008

Name:     ________________________________________________________    

Address:           __________________________________________                       

Phone Number:       _________________________________________________ 

Email Address:     _________________________________________________    

Number in Family:     ______________________________________________   

Ages of Participants:                 ________________________________              

 Tent Size and Number:         _________________________________________

Emergency Contact:                       _________________________________        

Persona Requested:       _____________________________________________

                 ________________________________________________                

Additional Information/Considerations/ Special Needs:                                   _    

___________________________________________________________________

Horses Number and Type                                            

Will you be participating in the auction, show or races?                                          

Please fill out this form and return it to:

Perryville Battlefield State Historic Site
C/O Joni House
PO Box 296
1825 Battlefield Road
Perryville KY 40468

Or email it to:joan.house@ky.gov

Registration closes on June 1, 2008.