Thank you for your interest in joining us for our event! The Pediatric Surge Tabletop Exercise will be held on March 17th, from 8 am-12 pm at the Maine Ice Vault (located at 203 Whitten Road in Hallowell, Maine). The exercise will be lead by Dr. Mark Cicero, Director of Pediatric Disaster Preparedness, at Yale University School of Medicine. This event is intended for emergency preparedness and pediatric healthcare professionals in Maine. Light breakfast refreshments will be provided to attendees. Please use the form below to confirm your participation in the exercise. If you have questions regarding your registration, or about the exercise, please contact Healthcare Coalition Coordinator Hannah James at HannahJ@AllClearEmg.com.


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* What is your first name?

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* What is your last name?

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* What is your job title?

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* What organization do you work for?

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* What is your email address?

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* What is your phone number?

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* If you have any dietary restrictions, please explain.

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