EMS for Children Program Pediatric Simulation Training in Southwest MN Question Title * 1. Name Question Title * 2. Agency/Hospital/Organization Question Title * 3. City/Town Question Title * 4. State Question Title * 5. Zipcode Question Title * 6. Email Address Question Title * 7. Phone Number Question Title * 8. Provider Level EMR EMT Paramedic Nurse Other (please specify) Question Title * 9. Which session would you like to attend? *Please note the morning session is FULL. * Morning (9am-1pm) FULL Afternoon (2pm-6pm) Question Title * 10. Thank you for registering! You will receive a confirmation email within 1-2 business days. If you do not get a reply email after 2 days, please call 612-813-6939 or email kjelsey.polzin@childrensmn.org. Done