4th Annual Battle of Lancaster
July 27, 28, 29th 2012
Registration Form
$5 per person / $20 per sutler
pre-registration paid by June 1st is required in order to receive amenities.
Make checks payable to: Battle of Lancaster Committee Mail registration
form and payment to:
Byron Teater
Battle of Lancaster
103 York St
Lancaster, KY 40444
Name
_____________________________ Rank____________
Unit Name ______________________________________________
Address ______________________________________________
City
________________ State ____________ Zip ________
E-mail
_____________________________________________
Contact Name __________________ Contact Number __________
Type of Portrayal (circle all that apply)
Confederate
Union
Civilian Sutler
Infantry Artillery Cavalry Medical
Sutlery Name _________________________________________
Types of items you sell: ____________________________________
By attending and participating in this encampment, I recognize that there are risks
attendant to this activity, including, but not limited to, open campfires, handling and use of black powder, discharge of
small arms and cannons. The risk of injury attendant to movement of large groups of people, the presence and use of horses
and/or other animals and risks associated with primitive camping. I hereby assume any and all risks occasioned by my presence
and/or participation in any and all activities in anyway related to the encampment. I further agree to release and hold harmless
the City of Lancaster, Battle of Lancaster Committee, , and the Lancaster United Methodist Church, Garrard County Goverenment,
and Garrard County Fairgrounds their agents, assigns, members, employees, directors and officers from any and all claims for
property damage or personal injury of any kind, no matter how incurred, sustained during my presence and/or participation
at the encampment or while on their properties.
I also agree to assign the City of Lancaster, Battle of Lancaster Committee, Lancaster
United Methodist Church or its assigns, the rights to use my image in recorded photographic images of the event without restriction
and do hereby waive all rights to compensation for same.
I further understand that this event is by registration and that I have read and
understand all of the event rules and any violation of those rules will result in a revocation of registration and, as a result,
I can be evicted from the event without notice or reimbursement of registration fees.
Signature: ________________________________ Date: __________________
List names of minor children less than 18 years of age: