Registration: Mizzou -- Peru-- Registration and Payment Deadline 03/22/19 (05-22-2019 - 05-29-2019 )

Below are the users that have already registered for this event.

Title First Name Last Name Organization/School Participant interest? Address City State/Province Zip / Postal Code Country Email Phone Gender Birthdate Passport Number Passport Issuing Country My passport is valid for at least 6 months AFTER departure date or I will have a new passport before departure Please enter contact information for 2 people we can contact in case of an emergency Please enter any special dietary needs (vegetarian, etc.) For emergency and planning purposes, please list any significant medical history, medications you are taking or known allergies I have read and accept this agreement Date Registered
MsAbbigailWebsterMizzouMedical101 Orr St Apt 203ColumbiaMissouri65201United Statesabbey.w2@gmail.com6608888128Female12-18-19970United StatesYesShannon Webster, 573-2392378 April Nixon, 660-888-9928Yes2019-03-10 18:20:28
MissAbbyBrigmanUniversity of MissouriMedical1222 E. Walnut, Apt 201ColumbiaMissouri65201United Statesabrigman97@yahoo.com7734585747Female10-03-19970United StatesYesKim Brigman 773 329 3954 Brian Brigman 630 833 2161Yes2019-03-10 18:21:34
MsAllisonDarmodyMizzouMedical9 Old Hickory CircleArnoldMO63010United Statesdarmodyallison@gmail.com3148037144Female03-20-1999535414187United StatesYesPat Darmody 314-757-2095 Pam Darmody 314-221-4643Yes2019-03-10 18:18:33
AnthonyAlvaradoUniversity of MissouriMedical14105 Buena Vista DriveUrbandaleIowa50323United Statesanthonyjosealvarado@outlook.com5153930907Male11-09-19990United StatesYesTammy Alvarado phone: 515-402=9019 address: 14105 Buena Vista Drive, Urbandale, Iowa Brett Ridge phone: 515-238-4511 address: 14105 Buena Vista Drive, Urbandale, IowaN/aMedications: adderall, trazedone, clonidine, truvadaYes2019-03-10 18:20:43
MissBethKnappenbergerUniversity of Missouri - ColumbiaMedical104 EVESHAM ELake Saint LouisMO63367United Statesbethknapp947@aol.com6362650080Female12-22-1997568308243United StatesYesGloria Knappenberger 636-578-0606 Barry Knappenberger 314-704-4281Yes2019-03-10 18:16:07
BriannaSappUniversity of MissouriMedical3906 Daylily ct.ColumbiaMissouri65203United Statesbree.sapp@gmail.com5734896322Female07-27-1999548315361United StatesYesAlyssa Sapp-573-999-0253 Brian Sapp-573-489-9287 Judy Sapp-573-289-8984birth control, xanaxYes2019-03-10 18:23:14
DorothyScalesMizzouMedical4522 EDEN HALL LNJOPLINMO64804United Statesscalesd@health.missouri.edu9038189447Female02-20-19980United StatesYesCharlotte Scales - 903-818-9447 Jonathan Scales 0 972-415-2664Yes2019-03-18 18:56:52
MsDrewKastenMizzouMedical212 Blackberry Ridge RdCape GirardeauMO63701United Statesdakgb9@mail.missouri.edu15732080824Female12-31-19990United StatesYesPriscilla Kasten- (573)270-3446 Mike Kasten-(573)979-0889Codeine-allergicYes2019-03-10 19:15:52
MissEmeraldMcKinleyMizzouMedical644 SW 101 RdWarrensburgMO64093United Statesmckinley.emerald@gmail.com816-832-9791Female07-18-2000571291037United StatesYesDustin McKinley- (660) 441-7526 Macae McKinley- (660) 441-7524NoneNoneYes2019-03-10 18:17:43
MissEmmaDiversUniversity of MissouriMedical1649 Eastbrook CircleMoberlyMissouri65270United Statesedivers18@yahoo.com6609985219Female06-03-20000United StatesYesPatti Divers (Mother)- (573)489-4709 dive5@sbcglobal.net Steve Divers (Father)- (660)998-1295 dive5@sbcglobal.netNoneNoneYes2019-03-10 18:21:07
MissEmmaKnickmanMizzouMedical1000 Virginia AveColumbiaMO65201United Stateseknic19@gmail.com3143789741Female02-12-20000United StatesYesAlicia Knickman (mother) 314-409-2880 knickman7@hotmail.com Judy Corwin (grandmother) 314-706-1220 asthma; albuterol sulfate rescue inhaler; allergic to: dogs, feathers, zinc oxideYes2019-03-10 18:31:32
MissHaileyMatthewMizzouMedical5776 State Hwy CCCassvilleMo65625United Stateshaileymatthew1212@yahoo.com417-342-1618Female08-14-19990United StatesYesJodie Coones 417-846-3362 Greg Matthew 417-393-0490Yes2019-03-10 18:19:50
HaleyHuffUniversity of MissouriMedical507 E Rollins stColumbiaMO65201United Stateshdeenhuff@gmail.com4178486055Female07-08-1998539859926United StatesYesKerri Huff (417)2344387 Sterling Huff (417)8616647Yes2019-03-10 18:17:46
HannahSmithUniversity of Missouri-ColumbiaMedical516 Beauford DrSt. LouisMO63122United Stateshnst33@mail.missouri.edu314-882-8381Female12-03-19960United StatesYes314-775-4033 314-409-2303Yes2019-03-12 10:39:51
MsJamieFureyUniversity of MissouriMedical1200 w 66th stKansas CityMO64113United Statesjamie.furey@live.com8168323838Female01-10-2000C19212968United StatesYesKristi Furey - 8168206258 Bernie Furey - 8168206248Long QT Syndrome - Nadolol Yes2019-03-10 18:15:34
JessicaYatesMizzouMedical803 Charles StKnob NosterMO65336United Statesyates.jf17@gmail.com8162230541Female01-28-1999549665145United StatesYes(816) 416-0186 (816) 585-7038Yes2019-03-10 18:19:53
MsJuliaPeifferMizzouMedical736 Arbor Haven Dr.BallwinMO63021United Statesjapqm6@mail.missouri.edu6365792200Female05-27-2000562754194United StatesYesJohn Peiffer Phone: 314-378-3678 Amy Peiffer Phone: 636-236-9565allergic to pennicillinYes2019-03-10 18:40:58
KaylaKielpMizzouMedical23054 Pilcher RdPlainfield Illinois60544United Stateskaylakielp87@gmail.com6306999306Female08-07-2000539657538United StatesYesTracy Marshall, 6308426062 Chris Kielp, 6304082796Yes2019-03-10 18:21:15
MsLaurenHenryMizzouMedical7731 Breckenridge AveKansas CityMO64139United Stateshenrylaure@health.missouri.edu8165369699Female09-06-1996502018649United StatesYesJennifer Henry 1(816) 935-6836 Ted Henry 1(816) 935-6840N/AN/AYes2019-03-10 10:05:18
MrLondonBalesMizzouDental18025 Kent CircleIndependenceMISSOURI64057United Stateslondonb98@hotmail.com816-728-9788Male11-19-1998563182538United StatesYesWendy Katamura (Mother) Phone:816-728-9788 Kyle Bales (Father) Phone:816-820-0275Yes2019-03-10 18:19:10

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