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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________________

Copyright 2002, Fifth Missouri Infantry C.S.A. Inc. This web site last updated Tuesday March 12, 2002 10:23:19 PM

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