CrisisReady Howard County
Event Registration
October - Fire Prevention and Response
and
Hands-Only CPR Training
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.
Please enter a valid phone number.
E-mail:
example@example.com
At which location do you plan to attend the CrisisReady presentation?
*
Greentown Century Villa Community Room on October 2nd at 6:30pm
Russiaville Lions Club on October 8th at 6:30pm
Kokomo-Howard County Public Library SOUTH Branch, on October 9th at 5:30pm (Please note the branch is different than usual)
Do you plan on attending the Hands-Only CPR first aid skills training immediately following the CrisisReady presentation. This training will take approximately 30 minutes. (A certificate is not provided for this course.)
*
Yes
No
I don't know yet
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 you consent to your picture, if taken, to be used in these reports and to posted to 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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