First, please fill out the registration below and click the “Next” button. When you see “Thank you - your form has been submitted,” please scroll to the bottom and click the “Continue to Payment” button.

**Please note that registration will not be complete until both the form and payment has been submitted. For assistance, please call 540-740-4545.

Name *

First Name

Last Name

What name would you like on your name tag? (Prefixes will be omitted)

Are you a Member? *

Yes

If you are a Member, please enter the code found on the back of your current membership card. For assistance, please call our offices at 540-740-4545.

Email *

Phone *

(###)

###

####

Please Register Me For *

Thursday

Friday

Saturday

Thursday Lunch Choice

(Registrants for Thursday who do not make a choice will be assigned a Turkey sub)

Turkey Sub

Ham Sub

Roast Beef Sub

Veggie Sub

Saturday Lunch Choice

(Registrants for Saturday who do not make a choice will be assigned a Turkey sub)

Turkey Sub

Ham Sub

Roast Beef Sub

Veggie Sub

Please check "No" if you will not join us for the Gala dinner on Friday evening.

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

If you are registering for additional people, please list the name(s) they would like on their name tag, their city and state, and any applicable lunch choices. (Blank lunch choices will be assigned a Turkey sub.)

Emergency Contact Name

Emergency Contact Phone

Medical Concerns

Accessibility Concerns

Thank you - your form has been submitted! Don’t forget to scroll to the bottom and click “Continue to Payment” to complete your registration.

Continue to Payment

Shenandoah Valley Battlefields Foundation
PO Box 897. 9386 S. Congress St. New Market, VA 22844 | Phone: 540-740-4545 | Fax: 540-534-1358 | info@svbf.net

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