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2023 Bank of America Chicago Marathon Ham Radio Medical Com Team
Event Date: Sunday, October 8, 2023
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First Name
*
Your answer
Last Name
*
Your answer
Callsign
*
Your answer
Street Address
*
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City
*
Your answer
State
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Illinois
Indiana
Iowa
Wisconsin
Michigan
Other:
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Postal Code
*
Your answer
Race Day Phone Number
*
Please use 000-000-0000 format
Your answer
E-mail address
*
Your answer
Have you worked the Marathon before as a ham radio operator?
Choose
Yes
No
Do you have a preferred assignment?
Your answer
Would you like to work with our Grant Park Roving Triage Teams?
Be prepared to walk or run long distances, assisting the roving medical teams in Grant Park
Yes
No
Contact me
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Will you be working the event as a part of a "Club Team"?
Which group? Please enter the full name, as several clubs have similar acronyms
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Do you prefer to be assigned to your Club Team?
Which group? Please enter the full name, as several clubs have similar acronyms
Prefer to be with my Ham Group
No preference, assign me where best deployed
T-shirt/Jacket Size
*
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S
M
L
XL
2XL (XXL)
3XL (3XXL)
I prefer not to receive a jacket
Were you a ham radio Aid Station Lead?
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Yes
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Emergency Contact Name
*
In case of an emergency, who should we contact?
Your answer
Emergency Contact Number
*
Please use the xxx-xxx-xxxx format
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Referral
Is there somone you know who might have an interest in this project, Send us their name and email address.
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Background
Briefly state your related background, training or experience serving large public events.
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