242 Strong: Recovery and Resilience Summit Registration Form
Please complete all required questions. Up to 5 registrants per form.
Name of Person Registering
*
First Name
Last Name
Age
*
Gender
*
Male
Female
Nonbinary
Other
Occupation
*
What is your Island of Origin?
*
What is your Island of Residence?
*
E-Mail Address
*
Phone Number
*
# Of Additional Participants Registering
*
1
2
3
4
Please List All Names of Additional Participants Registering
What are your needed items (please choose up to 10 per Participant)
*
Participant 1
Participant 2
Participant 3
Participant 4
Participant 5
Canned or packaged tuna
Canned beans
Canned vegetables and fruits
Breakfast bars
Crackers
Pretzels
Canned soup
Boxed milk
Chips
Ready to eat meals
Gatorade powder/powdered drink mixes
Fruit snacks
Diapers
Baby formula
Burping clothes and towels
Baby food
Baby cereal
Baby utensils
Bottles
Teething rings
Pedialyte
Baby aspirin
Paper towels
Garbage bags
Sanitizing wipes
Mops and buckets
Bleach
Chlorine tablets
Water containers
Household cleaning kits
Lysol disinfectant wipes/sprays
Toilet paper
Toothbrush, toothpaste, floss
Children’s toothpaste
Feminine hygiene products
Band aids, bandages
Hydrogen peroxide
Ibuprofen
Acetaminophen
Hand sanitizer
Rubbing alcohol
Gauze
Neosporin
Hydrocortisone
Bug/mosquito repellent
Clothes
Socks
Shoes
Sleeping bag
Tent
Blankets
Towels
Pillows
Bedsheets
Pillowcases
Air mattress
Flashlights
Candles and matches
Batteries
Non-electric can opener
Sterno Cookers
Sterno chafing pans
Charcoal
Submit
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