Cheshire Children's Museum CPR Registraion Form

Registration Form

Fill out the form carefully for registration.
Each participant must fill out this form and pay for the course.

This course is non-refundable but can be rescheduled. Please call 978-802-5324 to make those arrangements. Please be sure to either put in the comments the class you would like to attend or choose a class in the sections labeled, COURSES.
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile Number
Format: (000) 000-0000.
Student E-mail
example@example.com
Date

MonthDayYear
Date
Additional Comments
Course Dates: Please select the course date you wish to attend:

My Products: Please read each description carefully and choose the option that is best for you.

CPR, First Aid, AED Course

Choosing this option provides you an opportunity to learn the skills while obtaining an American Red Cross certification that is valid for two years.

$40.00 Quantity

Childcare Option Provided by Staff at Cheshire Children's Museum: Please note:

You will need to sign a waiver of liability acknowledging that the museum is not a licensed childcare provider. That waiver will be available the day of the class. The childcare option is for children between the ages of 5-10 years old.

$12.00 Quantity

CPR, First Aid, AED Course

Choosing this option provides you an opportunity to learn the skills but will NOT provide you a certification, that is why this option is at a discounted rate.

$10.00 Quantity

Total

$0.00

Payment Methods

Credit Card

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Google Pay

Cash App Pay

ACH Bank Transfer

Signature

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Registration Form

Each participant must fill out this form and pay for the course.

Payment Methods