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Step 1: MedWAR North Registration Form
*Indicates Required Field

Team Name*:

Affiliation: (School/Hospital/Organization)
Hometown: (City, State/Providence)

Team Captain

First Name*: Last Name*:
Occupation: (Physician/EMT/WFR/Student/etc.)
Email*:

Street Address*:
City*: State/Province*:
Country*: If other, Country:
Zipcode*:
Phone Number:

Captain Gear Rental*
($22.50 CAD for either with exchange between allowed. However, it is possible that they will run out of your size.)


If renting: Height: Weight: Ski Boot Size:

Vegetarian Option?*


(*We will attempt to accommodate, but consider bringing back-up.)

Team Member 2

First Name*: Last Name*:
Occupation: (Physician/EMT/WFR/Student/etc.)
Email*:

Team Member 2 Gear Rental*
($22.50CAD for either with exchange between allowed. However, it is possible that they will run out of your size)


If renting: Height: Weight: Ski Boot Size:

Vegetarian Option?*


(*We will attempt to accommodate, but consider bringing back-up.)

Team Member 3

First Name*: Last Name*:
Occupation: (Physician/EMT/WFR/Student/etc.)
Email*:

Team Member 3 Gear Rental*
($22.50 CAD for either with exchange between allowed. However, it is possible that they will run out of your size.)


If renting: Height: Weight: Ski Boot Size:

Team Member 3 Special Food Needs*


(*We will attempt to accommodate, but consider bringing back-up.)

Questions/Comments

 

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