Class Registration Form
Register for your preferred class by filling out the details below.
Full Name of Participant
*
First Name
Last Name
Age of Participant
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Select Class
*
Please Select
Saturday 10a to 2p
Saturday 12p
Sunday 10a to 2p
Sunday 12p
Comments or Special Requests (optional)
My Products
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Pediatric CPR/First Aid
10a-2p
$125.00
$
125.00
Quantity
1
2
3
4
5
6
7
8
9
10
Adult First Aid CPR AED Initial
$140.00
$
140.00
Quantity
1
2
3
4
5
6
7
8
9
10
Adult First Aid CPR AED Refresher
$99.00
$
99.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
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Buy with
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