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BAC Lifeguard Course Sign-up Form
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11
Questions
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1
How did you hear about our lifeguarding course?
*
This field is required.
Select all that applies.
BAC website
BAC email
BAC Facebook
BAC Instagram
Friend
Other
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2
Name of referral friend
First Name
Last Name
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3
Name
*
This field is required.
First Name
Last Name
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4
Email
*
This field is required.
This will be the email linked to your American Red Cross account.
example@example.com
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5
Phone Number
*
This field is required.
Please enter a valid phone number.
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6
Date of Birth
*
This field is required.
Please note: If taking the full lifeguarding course, you must be 15 years old by the last day of the course. You are required to bring a photo ID on the first day of the course for proof of age for the full cert and recert. You can bring a student ID and a birth certificate if you do not have a passport.
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Date
Year
Month
Day
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7
Parent/Guardian’s Name
If under 18 years old.
First Name
Last Name
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8
Do you have an expiring lifeguarding certification?
*
This field is required.
YES
NO
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9
Please upload your expiring Lifeguard Cert
If your cert expired over 30 days by the last day of the course, you will have to redo the full lifeguarding course.
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
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10
Lifeguard Course Date
May 6th and 7th 10 am-8 pm (May 20th Course is cancelled)
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11
Lifeguard Recert Course Date
May 7th 10 am-8 pm (May 21st Course is cancelled)
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