Step 1: Southeast MedWAR Registration Form *Indicates Required Field
Team Name*: Team Affiliation: (School/Hospital/Organization/etc.) Hometown: (City, State/Providence)
Team Captain
First Name*: Last Name*: Occupation: (MD/DO/RN/EMT/WFR/Student/etc.) Email*: Street Address*: City*: State/Province*: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Yukon Not Applicable Country*: U.S.A. Canada Other (enter below) If other, Country: Zipcode*: Phone Number: T-Shirt Size* S M L XL CME/CUE credit: Yes No (Also must register on CME page.) Special Food Needs* (We will attempt to accommodate, but have a backup plan.) None Vegetarian Kosher Other
Team Member 2
First Name*: Last Name*: Occupation: (MD/DO/RN/EMT/WFR/Student/etc.) Email*: T-Shirt Size* S M L XL CME/CUE credit: Yes No (Also must register on CME page.) Special Food Needs* (We will attempt to accommodate, but have a backup plan.) None Vegetarian Kosher Other
Team Member 3
Team Member 4
Camping (Included in regstration.) Friday & Saturday Nights Friday Night Only Saturday Night Only None How did you hear about MedWAR? Brochure/Flyer WMS group Other school group/organization Adventure race site posting Web search (Google, etc.) Word of mouth Other
Questions/Comments
Because there's more to survival than being the fittest...