Hall of Fame East-West Classic 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 East-West Classic Game on Saturday May 25, 2024.  

Time of events: 10:00 AM - 5:00 PM

Contact Mike Simons (email: michael.simons@cooperstownfd.org or (607)727-2218) with any questions.  Thanks!  
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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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