Part I: "GREAT SHAKEOUT" Sign-Up
MBFD and MBCERT are staging THE GREAT SHAKEOUT Exercise. The Great ShakeOut is when everyone, everywhere gets to practice how to protect themselves during an earthquake or other major disaster. Thus, The Great ShakeOut is for everyone. We are fully aware that skills are rusty, and it's okay. In fact, this is the perfect time to brush up on skills.
  • DATE: SATURDAY, OCT. 22, 2022
  • TIME: 8:00 AM - 12:00 PM [Check-In next to O'Donnell Hall.]
  • WHERE: AMERICAN MARTYRS CHURCH @ 700 15th Street, Manhattan Beach, 90266 [former address was 1431 Deegan Pl.]
  • BRING: CERT Bag, CERT Vest, Work Gloves, Hat/Helmet, Sturdy Shoes/Boots, Pen/Paper, Sunscreen ("Victims," please dress appropriately.)
Please complete this form for EACH participant. Thank you.

Vesta Sung 
Manhattan Beach CERT Association [MBCERTA]
Medical Response & Board Member
vestasung@mbcerta.org 
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Email *
Volunteer's FIRST Name *
Volunteer's LAST Name *
Are you an Adult (18+) or a Minor (Ages 11-17)? *
Participants must be at least age 11. Parent/Guardian release forms will be available at the event.
Volunteer's STREET Address (Line 1) *
Volunteer's STREET Address (Line 2)
Volunteer's Address CITY *
Volunteer's Address ZIP CODE *
Volunteer's CELL Phone *
What role will you volunteer for on Oct. 22? *
How did you hear about this drill? *
If you are not participating, why not? What could be done differently? 
Manhattan Beach CERT would like to know how we might help you participate next time. 
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