2026 Emergency Preparedness Tabletop Exercise Webinar

"*" indicates required fields

Facility Name:*

Facility Name

Facility Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Billing/Primary Contact Name*

First Last

Billing/Primary Contact Email*

Billing/Primary Contact Phone*

Pricing:*

$129 (Per Facility)

Evaluator Name*

First Last

Each Facility must have one person designated as the Evaluator for the EP Tabletop Exercise.

Evaluator Email:*

Required to validate attendance and to obtain access to the webinar.

Participant Name*

First Last

Each Facility must have at least one individual designated as the Participant for the EP Tabletop Exercise.

Participant Email:*

Required to validate attendance and to obtain access to the webinar.

Would you like to register additional staff to participate in the Table Top Exercise Webinar?*

Yes

Ideally, all staff designated with responsibility during an emergency situation should attend the EP Table Exercise and act as a Participant!

Enter the First/Last Name and email address for each additional Participant:

Please separate each name with a comma.

How Would You Like to Pay?*

Note: Check payments must be received by WHCA/WiCAL no less than 3 business days prior to the Seminar. If registering within 3 business days of the seminar, payment via Credit Card is required.

Check

Credit Card

Total Amount Due:

Service Charge for Credit and Debit Payments:

Price: $0.00

Credit Card

Card Details

Cardholder Name

Billing Address:*

Street Address Address Line 2 City State ZIP Code

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