2024 Simulation Competition Registration

What is your Team Name?

Team Member 1 (Primary Contact person)

Please enter the first team member's information. They will also serve as the primary contact person.

First name
Last name
Email	Email is already used by another user
Address 1
City
State
Zip code
Company
Mobile phone

Team Level of Service

Please note:

BLS teams must consist of 2 EMTs
ALS teams must consist of 2 Paramedics or 1 Paramedic, 1 RN, or MICN

Team Member 2

First Name	An answer is requiredFirst Name
Last Name	An answer is requiredLast Name
Email Address	An answer is requiredEmail Address
Mobile Phone	An answer is requiredMobile Phone

Photo Release:

All teams must be official registrants/attendees of the conference prior to competing in the competition. Photo Release for Conference, SIM Competition, and/or Awards Program Pictures and Videos: I hereby authorize, by nature of registering for the 2024 National Conference on EMS, 2024 SIM Competition, and / or 2024 EMS Awards Program, the NJ Office of Emergency Medical Services the absolute right and unrestricted permission to copyright and/or use, and/or publish, photographic portraits or pictures of me, still single, multiple, or moving, or in which I may be included in whole or in part, or composite, or distorted in character or form, in conjunction with my own or another or fictitious name, or reproductions of these photographs, in color or otherwise, made through any media at studios or elsewhere for art, advertising, trade, or any other lawful purpose.

I Agree