Western Re-enactor Group Registration Form

Name of Group/Team

Please provide the following contact information:

First Name
Last Name
Title
Phone
E-mail
Website

What area are you willing to cover?

How many active members?

Check any of the following that apply to your group:

Public Liability Insurance
First Aiders
Safety Officer
Pyrotechnics Licence

Select any of the following categories that apply:

Living History
Authentic Re-enactment
Hollywood Re-enactment
American Civil War
Other (Please detail below)

Other -please specify

How long has your group/team been performing (years)?

Any other relevant information

Previous performances for reference purposes