Living History Reenactment Association Member Application
Name:__________________________________________________________________
New member?_______ Y/N_____ Previous LHSA #:________________________
Mailing Address:______________________________________________________
City/State/Zip:_______________________________________________________
Phone:_________________________________________________________________
Cell Phone:____________________________________________________________
E-mail: ________________________________________________________________
Do you want your Newsletter by Mail or
E-mail?_________________________________________________________________
Are you a member of a LHSA unit? If so which one?
Y/N:____________________________________________________________________
Unit commanders Name, Phone__________________________________________
Email:__________________________________________________________________
By signing this application, I certify that I am at least 16 years of age, of sound mind, have no criminal record
and do not belong to any controversial political group. When admitted, I will obey all the rules and
regulations of the LHRA, Inc. , my individual unit(s), the laws of the community, the state and the Nation. I
understand that I am not a member of the LHS Inc. Untill such time as I receive my membership card. I
understand that if I violate any of the above-mentioned policies, membership may be revoked at any time
without refund and further membership can be denied. Membership dues are non-refundable.
(Applicant's Signature) _________________________________ (Date___________
.1 Year Membership= $25.00 (2-Year = $45.00) (3-Year = $65.00) (Lifetime = $300.00)
One, Two & Three Year Family Memberships available for an additional $1.00 Fee per year, per family
member
Make Checks/Money Orders Payable to: LHRA, Inc.
Mail form to:
Mike Booker
LHRA Secretary
224 Oak Leaf Ct, Apt D
Chesapeake, VA 23320