BACKUS HERITAGE
CONSERVATION AREA
PORT ROWAN, ONTARIO
1267 SECOND CONC.
R.R #1 PORT ROWAN,
ONTARIO N0E 1M0

2011 Backus War of 1812 Re-enactment Weekend September 10th and 11th

Re-enactor Application
Application deadline: August 22, 2011

Please fill in all the following information:

Please note: The Saturday evening meal will not be provided this year.

 

Number Attending:



Will you be bringing muskets? If yes, how many & what size(s):

Will you be bringing cannons? If yes, how many & what size(s):

Persons firing muskets and members of cannon crews require insurance.
Insurance Company: Insurance Policy:

For information contact Robin DeCloet, Heritage Programmer/Curator at 519-586-2201 toll free: 1-877-990-9932 or Email backusvillage@lprca.on.ca or Larry Hanna, Re-enactor Coordinator at 905-770-4743 or Email capt_haha@yahoo.com

        *Register Early - Space Is Limited.
        *You MUST BE REGISTERED in order to set up in the encampment.

I, declare on that the information provided above is accurate to the best of my knowledge. By submitting this application, I agree to allow the Long Point Region Conservation Authority to collect the information on this form in order to fulfill my registration for the War of 1812 Re-enactment event. The personal information contained on this form is for administration purposes only.

Long Point Region Conservation Authority http://www.lprca.on.ca