Reenactor Registration Thank you for your interest in being a reenactor with Westmoreland Historical Society. Please fill out the following form. Our Reenactor Guidelines can be found here. Contact DetailsName(Required) First Last Name of Unit / Group:(Required)Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Email(Required) Unit/Group DetailsNumber of Men(Required)Number of Women(Required)Number of Children(Required)Check all that apply(Required) American British Civilian Rangers Display Type / Number of Tents, Size:(Required)We are willing to demonstrate:(Required)Is there anything else you would like to share with us?(Required)Such as: questions, ideas, accessibility needsReenactor Guidelines ConsentA copy of our reenactor guidelines is available here.Reenactor Guidelines(Required) I [and my company, if applicable] voluntarily agree to the terms outlined in the Reenactor Guidelines.Insurance CertificateA copy of your insurance certificate must be forwarded to Westmoreland Historical Society prior to the event. In addition to uploading your insurance certificate via this form, you may also: Email Lara Bromyard directly at lara@westmorelandhistory.org or Mail to WCHS, ATTN: Lara Bromyard at 809 Forbes Trail Rd. Greensburg, PA 15601. Insurance CertificateMax. file size: 512 MB. This field is hidden when viewing the formRelease from LiabilityIn consideration of the permission extended to me by the Westmoreland Historical Society, Historic Hanna’s Town, and Westmoreland County Parks and Recreation to participate inand for other valuable consideration for myself, and/or my minor child/ward, my spouse, heirs, executors, administrators, personal representatives, and assigns do hereby FULLY AND FOREVER RELEASE AND DISCHARGE the above aforesaid, and their agents, representatives, employees, volunteers, and all persons whomever directly or indirectly liable, from any and all claims and demands, actions and causes of action, damage, costs, loss of services, expenses, and any and all other claims of damages whatsoever, both in law and equity, on account of, or resulting from, personal injuries, conscious suffering, death, or property damage suffered by me or my minor child/ward, whether directly or indirectly or in any manner connected to any of the activities on the premises of the aforesaid event. I am duly aware of the risks and hazards inherent upon entering said premises, en route to or from said premises, and participating in any activities held on said premises. In signing this release, I acknowledge and represent that I have read the above foregoing release, hold harmless and indemnification agreement, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement have been made; I am at least (18) years of age and fully competent; and I execute this release for full, adequate and complete consideration fully intending to be bound by same. I am responsible for all minors in attendance in our party and at no time will they be left unaccompanied. I acknowledge that I have read and understand the above terms. Reenactor Name (printed) and Date Reenactor Signature and Date WHS signature and Date