Registration

*Note: Membership to this portal is Verified. Once your account information has been submitted, you will receive an email containing your unique Verification Code. The Verification Code will be required the first time you attempt to sign in to the portal environment. All fields marked with an asterisk (*) are required.


First Name: Enter your First Name	*
Last Name: Enter your Last Name	*
User Name: Choose a User Name. If the user name already exists you will get an opportunity to select an alternate name.	*
Password: Choose a Password	*
Confirm: Re-Enter your Password to confirm the typing	*
Email: Enter your Email Address	*
Telephone: Enter your telephone number. Cell number is preferred.	*
Alt Telephone: Enter your alternate telephone number.


Address: Enter the Street part of your Address (eg 1 Main Street)	*
City: Enter the City	*
Country: Enter the Country	*
State: Select the State from the list	*
Postal Code: Enter the Postal Code	*

Emergency Contact Details

Emergency Contact Information is used for PACK outings in case of an emergency.

Emergency Contact Name: Enter the name of a person to contact in case of an emergency.	*
Emergency Contact Phone Number: Enter the phone number of a person to contact in case of an emergency.	*

Emergency Contact Additional Details:

Add any other information needed in case of an emergency.