Please review the form and complete the required field values.
Join us Saturday June 12, 2021 from 1p.m. - 4p.m. at the Hotel Hot Springs, 2nd floor lobby during the Arkansas Fire Convention in Hot Springs, AR.
Come on down to enjoy an afternoon of fun and fellowship, all to benefit the Arkansas Fallen Firefighters Memorial. There will be plenty of refreshments, and Emergency Medical Support staff will be on hand to address any medical emergencies.
If you have questions or need more information, contact Shane Dallas at (870) 261-2912.
Enter your first name.
Enter your surname.
Enter your street address
Enter your city
Select a state from the list
Enter your Zip Code
Enter the Fire Department you wish to represent
I understand and agree that I must sign a Waiver of Liability before participating in this event.
*No PayPal account is required, you may pay with a debit or credit card.
25.00 - 1 person - 25.00 USD
50.00 - 2 people - 50.00 USD
75.00 - 3 people - 75.00 USD
100.00 - 4 people - 100.00 USD
125.00 - 5 people - 125.00 USD
150.00 - 6 people - 150.00 USD