CrisisReady Howard County
Event Registration
September - Make Your Home Safer
and
Stop the Bleed training
Full Name
*
First Name
Last Name
Phone Number: If the CrisisReady event you have registered for is rescheduled at the last minute, we will call you to inform you of the change.
E-mail: Your Stop the Bleed certificate will be emailed to the email address you provide.
*
example@example.com
At which location do you plan to attend the CrisisReady presentation?
*
Greentown Century Villa Community Room on September 4th at 6:30pm
Kokomo-Howard County Public Library Main Branch, Meeting Rooms A & B, on September 11th at 5:30pm
Russiaville Lions Club on September 17th at 6:30pm
Do you plan on attending the Stop the Bleed first aid skills training following the presentation? The training will take approximately 90 minutes.
*
Yes
No
I don't know
If you plan on bringing friends or family with you and they are not registering, please provide an estimate of how many people will attend with you.
We take pictures of our events for social media and for local and state reports of our activities. Please confirm that youconsent to your picture, if taken, to be used in these reports and to posted to the social media.
*
Yes, any pictures I am may be used in the reports and posted to social media.
No, any pictures that I am should not be used in the reports or posted to social media. (You will have to let us know during the event so we can avoid placing you in pictures. We do NOT accept responsibility for accidentally posting your picture if we are not informed at the event.)
Would you like to receive a monthly email reminder about upcoming CrisisReady events?
Yes
No
Submit
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