Unit:

US or CS:

Infantry/Artillery/Cavalry:

 

Mounted?        

Can Galvanize?

 

Point of Contact

Name

Address

Phone

Email

Alternative Contact

Name

Address

Phone

Email

Members Attending

Name                                    Rank

Registration Fees

$5.00 per person         ($20 Cap per Family)

Total:  

Method of Payment

Pay Pal, Check or Money Order

Send Pay Pal Payment to bcr@dixie-net.com

Send Checks and Money Orders to

(Make Checks Payable To Brice’s Crossroads Battlefield Commission)

Brice’s Crossroads Battlefield Commission

607 Grisham St.

Baldwyn, MS 38824

Additional Comments

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