ON THE FARM -Registration Form

June 19-20, 2010

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 with fees to:

Perryville Battlefield State Historic Site
On the Farm
PO Box 296
1825 Battlefield Road
Perryville KY 40468

Fee Schedule: $15.00 per participant.
Children under 12 free.
 

Please make checks payable to Friends of Perryville Battlefield.

Registration closes on June 4, 2010.