HR 218 Registration Select Date * November 3, 2025 November 10, 2025 November 17, 2025 November 24, 2025 December 1, 2025 December 8, 2025 December 15, 2025 December 22, 2025 December 29, 2025 January 5, 2025 January 12, 2025 January 19, 2025 January 26, 2025 February 2, 2025 February 9, 2025 February 16, 2025 February 23, 2025 Full Legal Name * Date of Birth * MM DD YYYY Phone (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Emergency Contact Name * Emergency Contact Relation * Emergency Contact Phone * (###) ### #### Thank you!