EMRA MedWAR Interest Form

 

 

Wednesday, November 1, 2017
Seneca Creek State Park 

EMRA MedWAR Logo
Complete this form to indicate your interest in participating by July 15.
A drawing will be held on to determine the 12 competing teams

By completing this form, you agree that:
- All three team members will compete on Wednesday, November 1, 2017 at Seneca Creek State Park, Maryland. Team members are responsible for their own travel expenses
- Each team member will pay a $100 entry fee. Fee includes transportation to/from a Washington DC hotel to Seneca Creek State Park, post-race meal, a t-shirt, and awesome wilderness medicine experience
- Each team member agrees to pack his/her pack with medical supplies to compete in the race and food for the trail
- Each team member agrees to comply with proper trail rules. Team members will also sign a waiver before competing 

 

 

Team Name
Team Institution  
Team Members (including credentials)
Member 1  
Member 2  
Member 3  
Contact Person for team selection
Name       
Email  

 

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