Request for Event Coverage

Submitted by siobhan.watters on Sun, 06/28/2009 - 20:30

This form is used to request coverage by our Medical First Responders. It should be used for first contact only - not for follow-up discussion or emails. If you need to contact our Event Coordinator please email them directly, events@kwsja.ca

A copy of the information you enter will be sent to the email address you provide.

The more complete the form, the better the response and service will be.

Please note if your event is a multiple day event please submit a form for each date.

Please give us a brief description of your event to help us better plan the coverage.
Please give us the address and other relative information related to the location of your event.
:
:
ex: (555)555-5555
Please give us an estimate of how many people will be at your event.
$
All events must provide a donation. $150/4 hours is the suggested minimum.
This is not a mandatory field. Please include requests for vehicles, arrival times or other information.