Team Name *

*Subject to approval

Team Captain Name *

This person serves as the primary point of contact for the team. All information will be sent to this individual and asked to be distributed to other team members.

Team Captain Email *

Team Captain Phone Number *

Second Team Member Name *

Third Team Member Name *

Fourth Team Member Name
*

Are you Associated With a First Responder Discipline? *

Yes

No

We will reach out to the Team Captain with payment options once the team is registered.