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Postal Address:
Contact Person:
Phone / fax:
Email:
Name of Living History/ Reenactment Organisation/Group you belong to :
Organisation/Group Email:
Organisation/Group Web Site:
Brief description of YOUR intended impression(s) for the weekend :
Will you be bringing any Living History/ Reenactment vehicles or large equipment (give details)
Please provide a description INCLUDING serial number of any weapons-related items (real or replica) that you will have on the weekend
Do you have Living History / Reenactment public liability insurance cover ? : Yes No
Who is this Insurance Provided Through ?(eg ALHF,QLHF, Other (details required)):