1.Full Name

2.Date of Birth (M/D/YYYY)

3.We have two testing sites, which is the one that you want to register and time?

Hermiston Site - August 22 from 9am-12pm

Hermiston Site - August 22 from 12pm-3pm

Milton - Freewater - August 23 from 9am - 12pm

Milton - Freewater - August 23 from 12pm - 3pm

4.Gender

Female

Male

Other

Prefer not to say

5.Which of the following best describes you?- Select one answer

Asian or Pacific Islander

Black or African American

Hispanic or Latino

Native American or Alaskan Native

White or Caucasian

Multiracial or Biracial

Race/ethnicity not listed

6.Personal information to be contacted and registered to the event

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number