The Blue Company Membership Form
Name:
Address
City
State Post Code
Home Phone
Work Phone
Mobile
DOB dd/mm/yy Parent/guardian permission required if under 18 years
Email

Parents /Partners Name
Address
City
State Post Code
Home Phone
Work Phone
Mobile
Re-enactment groups you are a member of (if any)

Please copy this form and email it to blueco.historical@gmail.com

 or Post to

C. Penco: The Blue Company: PO Box 71 Woodville SA



 

 

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