WWII TRIBUTE at BUCKLEY
HOMESTEAD in LOWELL, INDIANA
RE-ENACTOR REGISTRATION FORM
PRE REGISTRATION REQUIRED
–
DEADLINE IS APRIL 6, 2009
May 1 & 2, 2010
Personal
Information
|
Name |
|
Address |
|
City
State
Zip |
|
Phone
(
)
Email (print clearly) |
|
Age: (circle one)
Under 16
Between 16-18
Over 18 |
|
Vehicle:
License #
State
Color
Make |
|
Do
you plan on participating in the battle or skirmishes?
Yes _______ No
_______ |
|
Re-enactor membership: Re-enactors must have a current membership in a recognized reenactment organization. Show current I.D. card at check in. HRS
Identification # __________________
TSG Identification # ______________________ Other
unit Identification # ______________
(List organization) BRING
I.D. CARD WITH YOU TO THE PROGRAM |
|
Medical emergency
contact name:
Medical emergency contact phone: List any health or
medical information the committee should be aware of:: |
Unit
Information (Clearly Circle Unit)
|
106th
Cav Recon |
2nd
Panzer |
5th
Ranger Batt E Co. |
B
Co. 502 Para Inf 101st |
|
11
SS Nordland Feldgendarmerie trupp 11 |
2nd
Rangers, Baker Co. |
5th
SS Wiking |
Baker
Co. 5th Ranger Batt |
|
116th
Inf., 29th Div |
2nd
SS Das Reich |
6th
Corp Radio Command Post |
Battaglione
Alpini Sciatori Monte Cervino |
|
11th
Field Hospital |
303
Bomb Group, US Army |
6th
SS Gebirg Div |
BTL
9th Sept |
|
12th
Army Grp HQ WAC |
327th
GIR 101st AB |
70th
Tank Battalion |
C
Comp 502 101st Air |
|
14th
Armor Infantry |
34th
Inf Div. U.S. Army |
715th
ID Panzerjager AB |
China
Marines |
|
165th
Signal Photographic |
353rd
Infantrie Div |
722
FK (German) |
Co
A 506 101st US |
|
19th
Volkssturm |
401
GIR, 101st AB C Co |
82nd
AB 504th |
Coldstream
Gds. |
|
|
41
Royal Marine (British) |
84th
ID Railsplitters |
Duke
of Cornwall’s Inf |
|
1st
ID Co L |
46th
Medical Hospital |
87th
MIR, 10th Recon |
F/K
Co 325th GIR 82nd AB |
|
1st
Polish Brigade Para |
4th
Div 10th Rep Depot |
90th
ID 359 Reg |
Fallschirmjager
Reg. 19 |
|
1st
SS LAH |
4th
Gebirgsjager |
95th
Rifles Russian |
First
Infantry Division |
|
1st
US I.D. |
4th
ID 8th RGT, D Co Inf |
9th
ID |
First
Special Service Force |
|
20th
Engineer Combat Bn |
501st
Parachute Inf Reg. |
9th
Panzer Motorcycle Batt |
G
Company 506th 101st A/B |
|
216th
MP Company |
502
Para Inf 101st B Co. |
9th
Parachute Regiment Co. A |
German
Afrika Korps impr |
|
21st
Panzer |
505th
PIR 82nd Airborne |
9th
SS Hohenstaufen |
Gross
Duetchland 5th Kompaine |
|
22
I.R. 4th I.D. |
506th
PIR Co Hq |
9th
SS Pz Div |
Herman
Goering |
|
2629th
WAC Battalion |
509th
Para Infantry Batt |
A
Company 506 |
No.
10 Commando, British |
|
29th
ID MP Platoon |
53rd
Provost Co. Brit MP |
Able
Co. 506 PIR/ 101 Div |
S-2,
7th Inf Reg. 3rd Inf Dv |
|
2nd
Inf Div |
Japanese |
ARC/ASG |
Third
Motorized German Inf |
|
OKW |
|
|
U.S.
1st Div. 16th Rgt. L. Co |
|
Unit commander’s name (required) Note:
CO or a representative of the unit must attend and be
responsible for the unit. No
individual reenactors. |
|||
Unit Affiliation (circle one)
|
British/Commonwealth |
German |
Italian |
|
Japanese |
Soviet |
U.S. |
|
Home Front |
USO |
MP Impression |
Other
Information
|
Specialized
impression (describe) |
|
MP
Impression __________
I will help in safety and crowd control Yes________
No ________ |
|
I
will participate in the uniform demonstration and share information
with the public on: Saturday
at 12:15 p.m._______ Sunday
at 12:15 p.m._______. (If
you check one or both of these times you will be contacted). |
Camp
Site and Vehicle Information
|
No
modern camping permitted – List the number of tents following the
description: GP
Medium (squad tent 16x12) _______
Pup Tent (6x6) ________
M1936 Pyramidal (16x16) ________ GP
Small (hexagonal tent 12x12) _______
Officers Wall Tent/Supply Tent (12x8) _________ Bell Tent _________ German Zelt _________ Other: List |
|
Number
of period vehicles ______________ Describe each period vehicle (use
other side if needed) Must
show proof of liability insurance (include insurance information
here). BRING
INSURANCE CARD WITH YOU. Insurance
company____________________________________ Policy number
___________________________ |
Mail
to:
Lake County Parks & Recreation Department (Attention: WWII) 8411 E.
Lincoln Highway, Crown Point, In 46307 OR Fax to 219-947-7210 OR
email
info@lakecountyparks.com
and request an email form