Standby Request

Manchester Volunteer Rescue Squad provides emergency medical services at specials events throughout the year. If you are interested in having our agency present at your event, please complete the request form below at least two weeks in advance of your event.

There is no fee for special events, but we appreciate donations for providing this service. Visit our donation page for more information.

"*" indicates required fields

Event Details

Name of Event*

Date*

Start Time*

End Time*

Location*

Street Address Address Line 2

Number of Spectators Expected*

Brief Description of Event:*

Type of Service Requested*

Ambulance

Bike Team

First Aid Station

Contact Person at Event*

First Name Last Name

Phone*

Requestor Information

Name of Group/Organization*

Name*

First Last

Address*

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

Phone*

Fax

Email*

Comments

This field is for validation purposes and should be left unchanged.

Event Details

Requestor Information

STATION 1

STATION 2