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.

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List any important allergies/ medical problems/ legal disabilities:

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Make Checks Payable to:
Contact Mike Hamilton for more Info, the link is on the homepage.