Eastern Kentucky EMS Symposium 2007 - Natural Bridge State Park - July 6th, 7th, and 8th
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Online Registration for Eastern KY EMS Symposium 2007

Registration Instructions

To register for the 2nd Annual Eastern Kentucky EMS Conference,just complete the form below and send us a check for your entrance fee. Its that easy!!! Entrance fee is $25.00 per person.

 

Once you submit this form, you will be redirected to a confirmation page with your confirmation number. Write this number in on your check in the memo area of the check. The address where to send the check will also be listed on the confirmation page.

 

 

* = Required Fields

General Information

 

Please Mark The Days You Plan To Attend
Friday
Saturday
Sunday
* Yes | No
* Yes | No
* Yes | No

 

 

Personal Demographics

 

First Name: *
Last Name:

*

Address: *
City: *
State: *
Zip Code: *
   
Note - Although it is not mandatory that you leave you contact numbers or email address when submitting this form, we would like to ask that you leave us with some way to contact you in case anything changes with the event. We will not share your personal information with any third party nor will we use this information in any other way outside of preparing for this event.
   
Email:
Home Phone:
Work Phone:
Cell Phone:

 

 

Work Demographics

 

Professional Title: *
Work Name : *
Work Address: *
City: *
State: *
Zip Code: *

 

 

Saturday and Sunday Afternoon Course Selection

Instructions

On Saturday and Sunday during the afternoon, we have two classes in which you can choose from three different tracks. Please complete the sections below so that we may add you to that class roster.

 

For more information on each lecture, please click on the lecture as it is listed below and a new window will appear with a small introduction to the given lecture.

About " Water Rescue"

If weather permits, on Saturday, this particular class will be held at the pool at the lodge. Because there is so much information to cover, this particular track will last through both class periods. Don't forget to bring your swim wear for those who want to get wet!

 

Saturday

Please pick one of the following:

Class 1
* Water Rescue | "Stand Off" - Tactical EMS N/A
   
Class 2 * Water Rescue | Hybrid Vehicle Hazards N/A
  (Must select Water Rescue in Class 2 if checked in Class 1)

 

Sunday

Please pick one of the following:

Class 1
* 12 Lead EKG | X-Ray Interpretation | Toxicology Emergencies N/A
   
Class 2 * 12 Lead EKG | Around the Clock | Code Blue - Simulation Lab N/A
  (Must select 12 Lead EKG in Class 2 if checked in Class 1)