2025 Wreaths Across America Registration Form

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Start Date: 2025-12-11       Departure Date: 2025-12-14

Poverty Point Reservoir State Park

  • Address: 1500 Poverty Point Parkway, Delhi, LA 71232
  • Phone: (833) 609-0686
  • For Reservations Contact: Campground

Sponsor(s): Cajuns

Host: Kathy Letsinger     Phone: (318) 366-8816     Email: Jkletsinger@gmail.com


Muster Costs:

Single Cost: $20.00   Couple Cost: $40.00   Couple + Guest Cost: $0.00  

Registration

An entry in all fields shown in the registration form is required.

Pilot:   SMART#:

Copilot:   SMART#:

   

Pilot's Email:

       

In Case of Emergency (ICE) Contact Information

Please provide at least one emergency contact other than your Copilot.

   

   

RV Information

       

       

I tow a vehicle behind my motor home.  

Attendees:   One Person $20.00.00   Two Persons $40.00.00   Two plus Guest $0.00.00

I (We) are first time attendee(s).

Guest Name:   Enter guest first and last names or “None.”

     

Handicap Parking         30 Amps   50 Amps

Do you or your traveling companion use any of the following, cane, walker, electric wheel chair, scooter, C-PAP?  

If Yes, please indicate which one(s):

Special Diet Needs  

His:  

Hers:

  I will volunteer to help at the Muster

Tours

  Tour#1 Laying Wreaths for Wreaths Across Americ - Cost: $0.00

We will participate in the worldwide effort of laying wreaths on veterans’ graves at the National Veterans’ Cemetery in Rayville, LA   Total: $

  Tour#2 Poverty Point World Heritage Site Tram T - Cost: $0.00

An entertaining and educational tour by State Park ranger.   Total: $

Liability Release

In consideration for my (our) attendance, I (We) hereby release and agree to indemnify and hold harmless SMART, its officers, directors, employees, agents, successors, and assigns from any and all liabilities, claims, losses, and/or damages arising from my (our) attendance at this event.

All attendees must read and sign this form.

Name Signature Date
Pilot:
Copilot:
Guest:

Total Submitted: $_____________________

Please mail a copy of this form along with your check, (payable to Cajuns), to Bo deBlieux, 10161 Hillsbury Drive, Baton Rouge, LA 70809.