Participant Information Form
Participant Name *
(first and last)
Your answer
Email *
Email address of person submitting form
Your answer
Cell phone
Cell phone number of IIMIF participant, if applicable
Your answer
T-shirt size *
All IMIF participants will receive a commerative T-shirt.
Medical Information
Please note any and all allergies, dietary restrictions, medications, or other important health information:
Your answer
Emergency Contact *
Person to contact in case of emergency (include name, relationship to you, email, and phone numbers):
Your answer
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