Event Request Form

Request medical services at your event

ER24's Specialised Medical Services Department (Special Events) is able to provide you with the necessary guidance and expertise to enable a holistic medical readiness plan for your event.

To book medical standby or enquire about having medical staff at your event, please complete the form below. An event co-ordinator in your region will then make contact with you.

Please enter your name and surname Please enter your name and surname in the required field.

Company Name

Please enter your contact number Please enter a contact number in the required field.

Please enter your email address. Please enter your email address in the required field.

In which Province will the event take place? If the event is taking place in multiple Provinces, please select National.

Please enter the town/suburb where the event will take place.

Please select the first date of the event. Please select the date in this required field.

Please indicate the type of the event.

Concert

Extreme Sport

Multiple Sport Event

Sport (Other)

Conference

Air Show

Public Gathering

Other

I have read and accept the terms and conditions of use.* This field is required.

Please don't fill out this field if you are a human being*

Spam protection (1 + 1 = ) Please add the two figures together (spam protection)