WFA registration

Wilderness and Remote First Aid
The Wilderness and Remote First Aid Class is being offered by Suncoast Wilderness First Aid.

An American Red Cross Licensed Training Provider.
REGISTRATION FORM
Full Name Of Participate*

First NameMiddle InitialLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
Date Of Birth:

MonthDayYear
Date
Location and Dates of Classes

Both classes at

Troop 12 _Lutz Scout Hut

205 Second Ave. S.E.

Lutz Fl 33549
Please pick your class date*
Current CPR/AED Expiration DateDate/Year
Certifying Agency Agency name
Scout Affiliation Scout position
Note

You can pay online by credit card or PayPal (process fee by Paypal extra $5) at https://suncoastwfa.com/class-price. Registration will be confirmed after receipt of payment and the registration form. CPR/AED for Community and Workplace class will be offered Saturday after the WFA course.. CPR/AED is included with the cost of the course NO extra charge. . CPR/AED class limited to 10 participants. If you are going to pay at the event add no pay the $5 fee..please email Sal at sal@suncoastwfa.com and let him know.
The class will be at a indoors and outdoors--PLEASE dress for the weather!

Time: 8am-5pm

You must be 14 years old and have current CPR/AED Certification by the last day.

Class is limited to 15 participants.
Please verify that you are human*
Should be Empty:

Wilderness and Remote First Aid