Activator Registration Form

Callsign (Club or Personal):

Name:
_{As it will appear on your certificate.}

Email:

Operator Class: Club Single Operator Single Park Single Operator Multiple Parks

Power Class: QRP Low Power (100w or less)

Operating Modes: SSB CW FT8 Other (Leave notes in Comments below.)
_{Choose whatever modes you plan on deploying}

Saturday Activation Location(s): ---Choose Park(s) None K-0636: Jekyll Island K-2165: A. H. Stephens K-2166: Amicalola Falls K-2167: Black Rock Mountain K-2168: Chattahoochee Bend K-2169: Cloudland Canyon K-2170: Crooked River K-2171: Don Carter K-2172: Elijah Clark K-2173: F.D. Roosevelt K-2174: Florence Marina K-2175: Fort McAllister K-2176: Fort Mountain K-2177: Fort Yargo K-2178: General Coffee K-2179: George L. Smith K-2180: George T. Bagby and Lodge K-2181: Georgia Veterans K-2182: Jack Hill K-2183: Hamburg K-2184: Hard Labor Creek K-2185: High Falls K-2186: Indian Springs K-2187: James H. (Sloppy) Floyd K-2188: Laura S. Walker K-2189: Little Ocmulgee K-2190: Magnolia Springs K-2191: Mistletoe K-2192: Moccasin Creek K-2193: Panola Mountain K-2194: Red Top Mountain K-2195: Reed Bingham K-2196: Richard B. Russell K-2197: Seminole K-2198: Skidaway Island K-2199: Smithgall Woods K-2200: Stephen C Foster K-2201: Sweetwater Creek K-2202: Tallulah Gorge K-2203: Tugaloo K-2204: Unicoi K-2205: Victoria Bryant K-2206: Vogel K-2207: Watson Mill Bridge K-3726: Kolomoki Mounds K-3727: Hart K-3728: Providence Canyon K-7858: Dames Ferry Campground K-7861: Suwannee River Eco-Lodge K-7896: Standing Boy Creek
_{To select multiple hold CTRL while selecting.}

Sunday Activation Location(s): ---Choose Park(s) None K-0636: Jekyll Island K-2165: A. H. Stephens K-2166: Amicalola Falls K-2167: Black Rock Mountain K-2168: Chattahoochee Bend K-2169: Cloudland Canyon K-2170: Crooked River K-2171: Don Carter K-2172: Elijah Clark K-2173: F.D. Roosevelt K-2174: Florence Marina K-2175: Fort McAllister K-2176: Fort Mountain K-2177: Fort Yargo K-2178: General Coffee K-2179: George L. Smith K-2180: George T. Bagby and Lodge K-2181: Georgia Veterans K-2182: Jack Hill K-2183: Hamburg K-2184: Hard Labor Creek K-2185: High Falls K-2186: Indian Springs K-2187: James H. (Sloppy) Floyd K-2188: Laura S. Walker K-2189: Little Ocmulgee K-2190: Magnolia Springs K-2191: Mistletoe K-2192: Moccasin Creek K-2193: Panola Mountain K-2194: Red Top Mountain K-2195: Reed Bingham K-2196: Richard B. Russell K-2197: Seminole K-2198: Skidaway Island K-2199: Smithgall Woods K-2200: Stephen C Foster K-2201: Sweetwater Creek K-2202: Tallulah Gorge K-2203: Tugaloo K-2204: Unicoi K-2205: Victoria Bryant K-2206: Vogel K-2207: Watson Mill Bridge K-3726: Kolomoki Mounds K-3727: Hart K-3728: Providence Canyon K-7858: Dames Ferry Campground K-7861: Suwannee River Eco-Lodge K-7896: Standing Boy Creek
_{To select multiple hold CTRL while selecting.}

I agree to the terms.
_{Activators must submit their logs to POTA.app so hunters get credit. Failure to submit logs to POTA will result in disqualification. After the contest, logs may also be uploaded to GA State Parks on the Air site.}

Comments: Share who might be operating with you. Are you camping? Did you reserve a shelter? If a club, who are the control ops? What times are you activating?

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