Dawn of a New Day Premier Exercise Victim Sign-Up

On Thursday, September 27th, from 12 PM-5 PM, Dayton MMRS will be putting on a mass casualty exercise hosted by Premier facilities. We are looking for volunteers to portray victims in these exercises. If you are interested, please fill out your information in the survey below. Thank you.

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First Name (Required.)

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Last Name (Required.)

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Email (Required.)

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Confirm Email (Required.)

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Gender (Required.)

Male

Female

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Age Range (Required.)

5-10 (must be accompanied by a parent)

11-15 (must have parental permission)

16-25 (must have parental permission if minor)

26-45

46-60

60+

Please bring closed toe shoes and clothing that can be cut or stained. Women should ware a tank top or sports bra for privacy.

We will provide information on exact times, what to do for the day of the exercise, and where to go in a follow-up email. If you are bringing additional volunteers, please submit a new form for each volunteer.

We look forward to seeing you in the victim prep rooms!

Question Title

* First Name (Required.)

Question Title

* Last Name (Required.)

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* Email (Required.)

Question Title

* Confirm Email (Required.)

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* Gender (Required.)

Question Title

* Age Range (Required.)

First Name (Required.)

Last Name (Required.)

Email (Required.)

Confirm Email (Required.)

Gender (Required.)

Age Range (Required.)