Name *

First Name

Last Name

Phone *

(###)

###

####

Dietary Requirements *

This will not affect your selection but we need to know for meal logistics.

None

Vegetarian

Vegan

Gluten Intolerant

Lactose Intolerant

Other (Describe below)

Aknowledgement *

Please check each statement acknowledging that you have read and agree to:

I agree to arrive to the exercise site no later than is stated on the exercise white paper

I agree to pay the stated participation fee to guarantee my slot

I agree to complete, prior to the exercise, required FEMA online coursework (IS100 Incident Command System)

If selected, I agree to fully abide by all exercise policies to include bringing all required clothing and equipment as per the online packing list

I understand that a photo release form is required in order to participate in the Missouri Hope Exercise