Registration - Water Safety Club

1

Name* This field is required

First Name

Last Name

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2

School name

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3

Email* This field is required

example@example.com

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4

Annual requirement 1We have reviewed our school’s written Cardiac Emergency Response Plan and made any necessary adjustments/modifications as necessary.

YESNO

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5

Annual requirement 2We have conducted at least 1 AED Drill this school year. In the following screen, you will be asked to upload your AED Drill Checklist.

YESNO

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6

Please upload the corresponding AED Drill Checklist from your drill.

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7

Annual requirement 3We check our AED monthly/per manufacturer directions and document each check. Please note, you are not required to upload your AED maintenance checklist(s) for this requirement.

YESNO

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8

Annual requirement 4We have conducted an all staff annual awareness training on Sudden Cardiac Arrest that includes the warning signs, recognition, communication procedures, other staff roles, etc. and our school’s Cardiac Emergency Response Plan.

YESNO

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9

Annual requirement 5We have checked/updated the CPR/AED training for our school’s Cardiac Emergency Response Team and trained/ensured that our members were trained in Hands Only CPR/AED training with observed compression practice this school year (for those NOT certified) and/or CPR certification is current for those who are certified. In addition, we have a system in place to track retraining as necessary. Please note, Project ADAM does not require that every member on your team be CPR certified, but the minimum standard is that those members who are NOT CPR certified receive annual Hands Only CPR/AED training with observed compression practice. Contact Project ADAM Texas for more information and available options for Hands Only CPR/AED training if interested.

YESNO

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10

Mailing address for your Heart Safe School sticker:

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Normal
Large
Huge

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11

Has it been 3 years since you submitted your Heart Safe School Checklist to Project ADAM? If it has, in the following screen you will be asked to upload your Heart Safe School Checklist. Note: All requirements must be in place and principal signature is required. Should you require assistance with any of the requirements or have any questions/concerns, you’re welcome to email ProjectAdamTexas@cookchildrens.org or call us at (682) 885-6755.

YESNO

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12

If you selected yes on the previous screen, upload your Heart Safe School Checklist here. Otherwise, click submit.

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13