Rocky Mountain Campus BLS/CPR Registration Form

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Pick a Course Date* This field is required.
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Manual Registration
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MANUALREG
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MAILCHIMP TAG
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Select the Training Provider you want to be certified with:* This field is required.
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Student Name* This field is required.
First Name
Last Name
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Student Email* This field is required.
example@example.com
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Phone Number* This field is required.
Please enter a valid phone number.
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BLS Registration Fee* This field is required.
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ORDER SUMMARY
Total costUSD
Basic Life Support (CPR) Certification
$80.00Edit
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Add-On your First Aid Certification!
$35.00Edit
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Total cost $0.00
Payment Methods
Credit Card
First Name
Last Name
Cash App
After submitting the form, you will be redirected to the Cash App Pay to complete the payment process.
Google Pay
After submitting the form, you will be redirected to the Google Pay to complete the payment process.
Apple Pay
After submitting the form, you will be redirected to the Apple Pay to complete the payment.
ACH Bank Transfer
Account Holder Name
Afterpay
After submitting the form, you will be redirected to the Afterpay to complete the payment process.
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BLS/CPR/First Aid Refund Policy

Students who choose to withdraw from the class may do so one day or more before the course start date. If the student withdraws during the period stated, they will be refunded 100% of any monies paid to Winder CNA Training. Refunds will be provided within thirty (30) calendar days of receiving notice of cancellation. Students who cancel on the day of the course or after the start of the course, will not be entitled to any refund. Students who are marked as a "no-show" to their course date will not be entitled to a refund and must register again to take the course.

Students must reserve their spot in the class by submitting their tuition payment in-full when completing their registration form. If the student cancels their registration past the refund window stated above, no money will be refunded.

The written notice must be sent to our address or emailed to
cancel@windercna.com.

By completing this registration form and submitting your signature, you agree to this refund policy of Winder CNA Training.
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Waiver of Liability

I, {studentName}, acknowledge that my participation in the training program offered by Winder CNA Training involves physical activity, including but not limited to clinical skills practice and potentially strenuous activities.

In consideration of being permitted to participate in the program, I agree to assume all risks and responsibilities for any injury or medical condition that I may sustain or aggravate during the course of the program. I understand that the program may involve physical and mental challenges, and I am responsible for ensuring that I am in good health and suitable physical condition to participate.

I hereby release, discharge, and hold harmless Winder CNA Training, its instructors, employees, and any affiliated entities from any and all claims, demands, liabilities, actions, causes of action, costs, and expenses, whether at law or in equity, whether known or unknown, arising out of or connected with my participation in the training program.

I understand that this Waiver of Liability Agreement is binding upon me, my heirs, executors, administrators, and assigns. I have read and voluntarily signed this agreement, and I acknowledge that I fully understand its contents.

By completing this registration form and submitting your signature, you agree to this Waiver of Liability policy of Winder CNA Training.
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Registration, Refund Policy, and Waiver of Liability Signature* This field is required.I understand the Liability Waiver, Refund Policy, and Course Date I've signed up for.
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BLS/CPR/First Aid Refund Policy

Waiver of Liability