Application October 31-November 2, 2014

Name(s):

Street address:

You must be at least 14 years old to enroll.

Ages 14 through 17 may enroll with an enrolling adult.
Age category:
[ ] Adult (21+ years old)
[ ] Young adult (18-20 years old)
[ ] Teen (14-17 years old)

REQUIRED: At least one phone number:

Primary phone:

Secondary phone:

REQUIRED: Your email address:

[ ] I am a WFAC graduate and I would like

to be a victim.

[ ] I am a medical professional or I have completed a wilderness first aid course of

24 hours or more and I would like more information about being a victim during scenarios (See advantages.)

[ ] I have a van, large SUV, station wagon, or large truck with a camper shell (minimum cargo area of 150 cu.ft.) and I'm willing to haul course gear to the lodge Thursday afternoon, for enrollment priority or compensation.

[ ] I am willing to help sign students in.

WFAC needs 4 early-bird students to sign in the other students.

Start tasks at 7:00 a.m. to sign in your fellow students at 7:15 a.m. Get the best seats in the classroom, meet all the other students, and contribute to a good cause!

[ ] I prefer vegetarian meals.

(We will do our best, but offer no guarantee.)

Is your submission complete?

Please use the following checklist for a complete application. For example, if you have enrolled in a CPR course, wait until you have the CPR card before submitting your application and fee.

[ ] I have read the Participation Release and agree that I will sign it.

[ ] Completed printout of this form

[ ] Signed check made to WFAC ($220 all students--no checks that expire in 90 days, please)

[ ] Copy of the CPR card (completed no more than 4 years prior to the date of the WFAC)

NOTE: WFAC returns incomplete submissions.