Ohio Staff Information Sheet
National Event Services, Inc (NES) is a global provider of Event Medical staff, serving some of the largest music festivals in the country. NES will provide the on-site medical services for the Lost Lands Music Festival in 2021.

If you are interested in joining the team for 2021, please fill out the below form in its entirety.

This form will be used to gather information of EMS providers' information to establish a list of personnel to work Lost Lands. Please answer these questions entirely. Beginning around July 1st, once certifications are verified, we will reach out and start scheduling staff. Please feel free to forward this link to any other qualified EMS providers that may be interested in working this years Lost Lands. You MUST be a certified/licensed Ohio practitioner to work this event, out of state certifications will not be valid. Reciprocity information can be found here: https://www.ems.ohio.gov/certifications-reciprocity.aspx#gsc.tab=0

Lost Lands is scheduled to be held September 24-26, 2021, at Legend Valley in Thornville, OH
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Last Name (OFFICIAL): *
First Name (OFFICIAL): *
Cell Phone Number (NUMBERS ONLY - NO DASHES): *
Cell Phone Carrier: *
Email Address: *
Date of Birth: *
Address (### Street, TOWN, STATE, ZIP) *
Certification Level: *
Certification Number (if not an EMT / Medic, please put N/A) *
Have you worked Lost Lands in the past? *
What size t-shirt do you wear? *
While National Event Services does not require applicants to be vaccinated for employment, some of our clients may require working staff to be vaccinated. Have you received the COVID19 Vaccination?
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Do you anticipate on commuting to work each day or will you be camping on site?
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