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This document is a registration form for participating in the Prairie State CERT Challenge which includes a liability release statement for the state of Illinois.
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How to fill out Illinois Emergency Management Agency Individual Registration Form and Liability Release

01
Obtain a copy of the Illinois Emergency Management Agency Individual Registration Form and Liability Release.
02
Fill in your personal information, including full name, address, phone number, and email.
03
Indicate your date of birth and any relevant medical information or special needs.
04
Provide emergency contact details, including name and phone number of the person to be contacted.
05
Review the Liability Release section carefully and ensure you understand the terms.
06
Sign and date the form where indicated.
07
Submit the completed form to the appropriate local emergency management office or designated agency.

Who needs Illinois Emergency Management Agency Individual Registration Form and Liability Release?

01
Individuals participating in emergency management programs or volunteer activities in Illinois.
02
Persons seeking to assist during disasters or emergencies as part of a registered organization.
03
Community members who want to receive training or participate in emergency response initiatives.
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It is a form that individuals must complete to register for participation in emergency management activities and to acknowledge their understanding of the risks involved, thereby releasing the Illinois Emergency Management Agency from liability.
Individuals who wish to participate in disaster response training, volunteer opportunities, or any emergency management-related activities are required to file this form.
To fill out the form, individuals should provide their personal information, including name, address, contact details, and any relevant background information. They must also read and sign the liability release section.
The purpose is to ensure that individuals are aware of the potential risks associated with their participation and to protect the agency from legal claims resulting from participation in emergency management activities.
The form requires reporting of personal details such as name, address, phone number, email, emergency contact information, and acknowledgment of risks involved in activities.
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