Flags of Liberty Registration

Flags of Liberty Registration

Please complete all lines and options on form below. Specify the name of the Veteran you are honoring on July 4th at sunrise, North Wildwood, NJ. A confirmation email will be sent.
Full Name *

First Name Last Name
E-mail *
Mobile Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Please check one of the four OPTIONS:

Attending and bringing my loved ones Veterans Flag to unfurl Attending and need a loaner Veteran Flag to unfurl Can not attend, please have volunteers unfurl a Flag to honor my Veteran May or may not attend, please accept my Contribution toward the event
Name of Veteran whose burial flag you or volunteers will unfurl *

First Name Last Name
Military Branch Served *
This is a fill in the blanks field. Please add appropriate blank fields and text.
Registration Fee / Contributions benefit Veterans and Veteran Families in need. Deb Moore Ministries is a non-profit 501 (c) 3 organization – Tax ID# 81-1909457 PA and NJ BR Certification

$20 Registration Fee *

USD $20 Registration Fee benefits Veterans and Families and includes your T-Shirt and Keepsake. Additional T-Shirts will be available at the event. Thank You!

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

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