Municipality of Skagway Ground Ambulance Subscription

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This subscription covers all Skagway EMS ground ambulance services.
After completing this form, you will be prompted to contact City Hall to provide payment.

Any person may subscribe for ambulance service for a fee of $10 per person per fiscal year or $25 per family per fiscal year. The fiscal year will run from January 1 through December 31 of 2024. A family is defined as immediate family living in one household for purposes of the subscription fee.
The base rate is waived for subscribers; however, charges for transportation, supplies and madivac escort are not waived.

Your Full Name *

Family Member Name #1 (related & living with you)

Family Member Name #2 (related & living with you)

Family Member Name #3 (related & living with you)

Family Member Name #4 (related & living with you)

Family Member Name #5 (related & living with you)

Family Member Name #6 (related & living with you)

Physical Address *

Mailing Address (P.O. Box) *

Phone Number *

Select Subscription Type *

Individual

Family

E-Sign *

I hearby agree to the terms and conditions of the Municipality of Skagway Ambulance Subscription.

Required

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