PRINT the following form and return to

Gen. John Herbert Kelly

Camp 1980 S.C.V.

P. O. Box 173

Gordo, AL 35466

I ________________________________________ do solemnly promise and affirm

that I will bear true faith and allegiance to the Ala-Sippi Rifles, that I will serve it

honestly and faithfully, that I will observe and obey all orders of the officers

appointed over me according to the rules and regulations of the Company.

I declare that I am ____ years of age and know of no impediment to my serving

honestly and faithfully as a soldier in this Company. I also promise and comfirm

that I shall hold neither any person in this Company nor any property owners

responsible for any accidents or injuries that may occur while participating in any

functions of the Ala-Sippi Rifles.

Signed   _____________________________________

Address  _____________________________________

              ______________________________________

Phone     (______)________________