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
*
Please Select
1
2
3
4
Please List All Names of Additional Participants Registering
1
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
2
3
4
5
6
Canned beans
7
8
9
10
11
Canned vegetables and fruits
12
13
14
15
16
Breakfast bars
17
18
19
20
21
Crackers
22
23
24
25
26
Pretzels
27
28
29
30
31
Canned soup
32
33
34
35
36
Boxed milk
37
38
39
40
41
Chips
42
43
44
45
46
Ready to eat meals
47
48
49
50
51
Gatorade powder/powdered drink mixes
52
53
54
55
56
Fruit snacks
57
58
59
60
61
Diapers
62
63
64
65
66
Baby formula
67
68
69
70
71
Burping clothes and towels
72
73
74
75
76
Baby food
77
78
79
80
81
Baby cereal
82
83
84
85
86
Baby utensils
87
88
89
90
91
Bottles
92
93
94
95
96
Teething rings
97
98
99
100
101
Pedialyte
102
103
104
105
106
Baby aspirin
107
108
109
110
111
Paper towels
112
113
114
115
116
Garbage bags
117
118
119
120
121
Sanitizing wipes
122
123
124
125
126
Mops and buckets
127
128
129
130
131
Bleach
132
133
134
135
136
Chlorine tablets
137
138
139
140
141
Water containers
142
143
144
145
146
Household cleaning kits
147
148
149
150
151
Lysol disinfectant wipes/sprays
152
153
154
155
156
Toilet paper
157
158
159
160
161
Toothbrush, toothpaste, floss
162
163
164
165
166
Children’s toothpaste
167
168
169
170
171
Feminine hygiene products
172
173
174
175
176
Band aids, bandages
177
178
179
180
181
Hydrogen peroxide
182
183
184
185
186
Ibuprofen
187
188
189
190
191
Acetaminophen
192
193
194
195
196
Hand sanitizer
197
198
199
200
201
Rubbing alcohol
202
203
204
205
206
Gauze
207
208
209
210
211
Neosporin
212
213
214
215
216
Hydrocortisone
217
218
219
220
221
Bug/mosquito repellent
222
223
224
225
226
Clothes
227
228
229
230
231
Socks
232
233
234
235
236
Shoes
237
238
239
240
241
Sleeping bag
242
243
244
245
246
Tent
247
248
249
250
251
Blankets
252
253
254
255
256
Towels
257
258
259
260
261
Pillows
262
263
264
265
266
Bedsheets
267
268
269
270
271
Pillowcases
272
273
274
275
276
Air mattress
277
278
279
280
281
Flashlights
282
283
284
285
286
Candles and matches
287
288
289
290
291
Batteries
292
293
294
295
296
Non-electric can opener
297
298
299
300
301
Sterno Cookers
302
303
304
305
306
Sterno chafing pans
307
308
309
310
311
Charcoal
312
313
314
315
316
Submit
Should be Empty: