Print this document on your printer, fill out and mail to address on the bottom of this form.
I,_____________________________________, desirous of defending my State against the Northern Invader, apply for membership in the Fifth Missouri Infantry CSA Inc. I certify that I am of legal age and suffer no undisclosed physical, legal or mental disabilities which would prohibit me from bearing firearms or would endanger myself, other re-enactors or the general public. I further agree to comply with the by laws, safety rules and behavioral guidelines of the Fifth Missouri Infantry (CSA) Inc., and to comply with the instructions and directions of those elected or appointed to positions in control of this and other units & events, as long as such instructions and directions are legal, safe, & non demeaning. I understand that I must undergo a probationary training period under close supervision for safety and authenticity purposes before being accepted as a Veteran Soldier.
Signature____________________________________________________________________
Address_____________________________________________________________________
City____________________________ State_________ Zip Code_______
Phone__________________________ Email_________________________
Date____________________________
Membership (check
one)
[] General $22.00
($12.00 Fifth MO & $10.00 MCWRA)
[] Associate $9.00
(Non voting member)
Names (& ages if under 16)of family members included in membership.
_______________________________________________________________________________
List any important allergies/ medical problems/ legal disabilities:
_______________________________________________________________________________
Make Checks
Payable to:
Fifth Missouri
Infantry CSA Inc.
920 West Broadway
Columbia, MO 65203
Web page Source
LD 12800
Membership
Number________________
The Fifth Missouri Infantry C.S.A. Inc. is not affiliated with any religious, political, or any connection with hate organizations.
Contact Site Administrator at renact4@hotmail.com