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Siege of Fort Randolph 2010 Registration Form and Liability Release
Name: ____________________________________ Phone: _____________________
Address: _______________________________________________________________
E-mail _____________________________ Group name: _______________________
Militia _____ Civilian ______ Sutler ______ Type of tent: ______________________
I am planning to set up camp on: ____________ Time: ________________ (approx.)
Number of members in your camp: ___ Names of other members: _______________________________________________________________________ _______________________________________________________________________
I am available for the Friday school tours: _____ I am able to do a demonstration on:____________ for the weekend. I would like to have a speaking part in the drama: ____ I would like to have a non-speaking part in the drama: _____ I can bring _________________________ to use during the drama. (Bucket, pitchfork, etc.) I can donate _______________ for the auction. I will bring _____________ for the meal on Saturday night.
I do hereby, for myself, my heirs, my executor or administrator, release and forever discharge any and all rights and claims, for, or to be, for which I or members of my family may have or which may hereafter accrue to me or my family against the Fort Randolph Committee and/or any other person connected and scheduled committee activities individually, or collectively, for all responsibility for injury to persons during these activities.
Signed: ________________________ Signed: _________________________________
Fire wood, straw and showers are available. Only Native Americans will be allowed to camp in the Indian Village. Civilian, Militia and Sutlers will camp in designated areas. Please check with one of the event organizers before setting up your camp. Wedge tents for the militia will be allowed to camp inside the walls. Cabins inside the fort are on a first come basis.
For pre-registration please mail to: Fort Randolph PO Box 86 Point Pleasant, WV 25550
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