Training Registration Form
Templo Pentecostal del Dios Viviente 1921 Walton Ave Bronx NY 10451 November 21, 2026 (One Type of Training Per Application )
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Section
*
Outpost Number
*
Church Name
*
Ranger Safety Candidate List Only ($20)
First-Aid/CPR/AED Candidate List Only ($80)
Leadership 204 Candidates Only ($15)
Total Owed For All Trainings
Payment Amount
*
prev
next
( X )
USD
Total for ALL trainings
Credit Card
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