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class registration form

Use this form to register for all available training classes. Incomplete forms may result in your registration being deleted and/or your services being delayed. Once we receive your request, we will contact you to confirm the details and process your payment.
I would like to register for a training class. A CHECK IN THE BOX IS REQUIRED TO REGISTER
First Name Last Name Phone E-mail Company or Organization
Select a prescheduled class date or request an alternate below. NOTE* If you are requesting a class on your company's site, please use the alternate date block.
September 4, 2024 - Adult Child Infant CPR AED First Aid - $65 per person - OPEN
September 11, 2024 - Adult Child Infant CPR AED First Aid - $65 per person - OPEN
September 18, 2024 - Adult Child Infant CPR AED First Aid - $65 per person - OPEN
September 22, 2024 - Adult Child Infant CPR AED First Aid - $65 per person - OPEN
October 2, 2024 - Adult Child Infant CPR AED First Aid - $65 per person - OPEN
The above dates don't work for me. I want to schedule a different class date. Your 2ND proposed alternate date What class do you want to schedule?
How many participants will you have? Select one
Individual or Self
Group (2-7 people) List full names of all participants in comments
Group (8-12 people) List full names of all participants in comments
Group (13+ people) List full names of all participants in comments. Training will be scheduled on two separate class dates.
Class location. Select one
On my site (must have amenities listed below)
Select a site for me
Other (Please specify details in comments)
If you are scheduling at your site, does it have the following amenities available? Check all that apply
Tables/Desks/Chairs
Television with HDMI ports
Classroom or Conference Room
Working restrooms
External speaker (Only if TV doesn't have one)
HDMI cable at least 20 feet long
I would also like to schedule the following services
I also want to purchase the following equipment: Check all that apply
TACPAC Emergency Kit
AED Wall Mounted Box
AED
CPR Mask Kit (Reusable)
CPR Mask Kit (Disposable - Keychain)
Nothing at this time
Additional Comments I agree to the Terms & Conditions and Privacy Policy Submit