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Online 2024 Membership Application & Payment

Application Type

New Application

Renewal

First name

Last name

RGA Number (For Renewals Only)

Alias

Street Address

City

Region/State/Province

Postal / Zip code

Phone

Email

Group Associations

My Interests (select as many you like)

Old West Performances

Historical Portrayals/Living Histories

Encampments

Other (specify)

Specify Other Here:

Select One:

My information can be shared within the organization to keep me informed about RGA

Please do not share except with the National office and my State Director

Upload FULL-LENGTH Image

Upload supported file (Max 15MB)

Terms & Conditions

I agree to the terms & conditions

Is Re-Enactor 18 Years of Age or Older?

Yes

No

Guardian First Name

Guardian Last Name

Date of Application

Select an item ($)

Single Membership with RGA Insurance - $45

Youth (Under 18) - $25

Thanks for submitting!

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