Volunteer Registration Form for Rotary CPAD Guardians

Volunteer Registration Form for Rotary CPAD Guardians

Join our community to help save lives by becoming a Rotary CPAD Guardian. Please fill out the form below to register as a volunteer.
I confirm I wish to become a volunteer Rotary CPAD Guardian and as such will also become a Friend of Rotary.

I understand that I will be committed to undertaking checks on the AEDs allocated to me and that as a Rotary CPAD Guardian

I will receive updates and occasional newsletters via email to the address I enter on this registration.

I also understand that my personal data will not be shared and will be covered under data protection laws of the UK

I also commit to advising Rotary if I am unable to continue acting as Guardian to the AEDs allocated and will inform them as soon as physically possible.
Full Name*

First NameLast Name
Photo Id*

Required for Photo Id Card
Cancelof
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Home Address*

Street Address

Street Address Line 2
CityCountyPost Code
Emergency Contact Name
Emergency Contact Phone Number
Please enter a valid phone number.
Do you hold any relevant certifications?

CPR CertificationFirst Aid CertificationEmergency Medical Technician (EMT)Other
What motivates you to become an AED Guardian?*
Do you have prior experience with AED devices or emergency response?*

YesNo
If yes, please describe your experience
I agree to the terms and conditions and consent to participate as a volunteer AED Guardian.*
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