Community Emergency Response Team (CERT) Training Class Registration Form

The City of Hampton Emergency Management Department will be offering the Community Emergency Response Team Training Class several times each year. The class features a combination of in-person and virtual learning.

Below are the topics covered:

Disaster Preparedness
Disaster Medical Operations Part 1
Disaster Medical Operations Part 2
Light Search & Rescue
Fire Suppression
CERT Organization & Disaster Psychology
Terrorism
FINAL PRACTICAL EXERCISE

The hybrid format features:

Online training: can be accessed ony your mobile device or computer and completed at your own pace and on your own time.
FINAL PRACTICAL EXERCISE - Opportunity to practice the skills learned.

To register for the CERT class, please fill out the information below and you will recieve information regarding upcoming class sessions.

Name:*

First NameLast Name

Email:*

example@example.com

Home Number:

Please enter a valid phone number.

Mobile Number:

Please enter a valid phone number.

Work Number:

Please enter a valid phone number.

Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Neighborhood/Subdivision:

In case of emergency, please notify:

Relationship:

Home Number:

Please enter a valid phone number.

Mobile Number:

Please enter a valid phone number.

Do you have previous disaster-related training or experience?:

YesNo

Are you able to complete all 8 sessions and final exercise to obtain a FEMA certificate?:

YesNo

Do you need accommodations to preform the requirements of this training?:

YesNo

If yes, what accommodations do you require?:

Are you taking this training for personal use or to be a CERT Team Member?

Personal useCERT Team Member

Do you wish to hear about what else is going on in Hampton?

YesNo