Hall of Fame Induction Weekend Sign Up
Use this form to sign up to help the Cooperstown Fire Department Emergency Squad with stand by coverage for the Hall of Fame Induction Weekend (Saturday July 20th and Sunday July 21st).  

Contact Mike Simons (email: michael.simons@cooperstownfd.org or (607)727-2218) with any questions.  Thanks!  
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What events can you help with? (select all that are available for)
Are you interested in camping July 20th?
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First Name: *
Last name: *
Date of birth: *
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NYS level of certification: *
EMS Certification/License Number *
Expiration Date *
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Street Address: *
City: *
State *
Zip Code: *
Cell Phone Number (with area code): *
Email address: *
Home/primary agency: *
What events have you worked for us in the past?
If you need a yellow Hall of Fame EMS shirt, what size?
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