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REQUEST EMS WHITE KNIGHTS COVERAGE FOR YOUR EVENT

    Please Note: EMS White Knights provide coverage at your event in lieu of any registration fees.

    *Please Complete all Blank Spaces *

  • Organization Address

  • Event

  • Include The Following If Applicable:

  • Coverage Details

  • Donation

    (As a charitable organization, with service provided by volunteers, a Donation would be greatly appreciated, Than You.)

  • Please submit ONE duty request for each separate event, requiring First Aid Coverage. If the event occurs on consecutive days, only one duty request is required.

    Note: It is the responsibility of the event sponsor to notify EMS White Knights of any site/location changes at least 7 days prior to the event taking place.

 

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