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	* First Name Is Required
Last Name: Enter your Last Name	* Last Name Is Required
User Name: Choose a User Name. If the user name already exists you will get an opportunity to select an alternate name.	* User Name Is Required User Name cannot contain spaces.
Display Name: This is your public identity on the site - how other members will see and refer to you. You can change this anytime without affecting your login credentials.	* Display Name Is Required
Password: Choose a Password	* Password Is Required
Confirm: Re-Enter your Password to confirm the typing	* Confirm Password Is Required Password Values Entered Do Not Match.
Email: Enter your Email Address	* Email Is Required Enter a valid Email. user@dmomain.com
Telephone: Enter your telephone number. Cell number is preferred.	* Telephone Is Required
Alt Telephone: Enter your alternate telephone number.


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

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 Name Is Required
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.