Course Registration Form

Lifeguard and/or CPR Course Registration Form

Fill out the form carefully for registration. (Content for Lifeguarding Course will be emailed to you to complete online portion PRIOR to course date). PLEASE EMAIL UNITEDPOOL60@GMAIL.COM IF YOU HAVE ANY QUESTIONS ABOUT THE NEXT LIFEGUARDING COURSE!!!
Full Lifeguarding and Recert: $250, CPR Only: $120

Payments must be paid in person, on the day of the course, CASH ONLY!!! It's an addition $10 if you don't have a CPR mask, which is required for all the course.
LIFEGUARD COURSE PREREQUISITES *Swim 150 yards breaststroke AND/OR freestyle with face in water *Immediately tread water for 2 minutes using only legs & finish swimming 50 yds breaststroke AND/OR freestyle continuously *Retrieve 10 lb brick then kick on back w/ brick (under 1 min 40 secs)

MUST BE 15 YEARS OR OLDER BY THE LAST DAY OF THE FULL LIFEGUARD COURSE, 17 YEARS OLD FOR RECERTS!!!
Student's Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Place of Residence City and State*
Student E-mail to be linked to Red Cross account*
example@example.com
Mobile Number*

Area CodePhone Number
Course*
Please upload your expiring Lifeguard Certificate.*

Browse Files

Cancelof
YESNo
Last day of school before summer break*

MonthDayYear
Date
First Date of Availability for Course*
Second Date of Availability for Course*
Third Date of Availability for Course*
Additional Comments
Should be Empty:

Lifeguard and/or CPR Course Registration Form