Course Registration Form

Babysitter's Training and Pediatric First Aid/CPR

Enrollment Form
Complete the form below to enroll in the Babysitter's Training with Pediatric First Aid/CPR scheduled for March 24th and 26th from 8:30 AM to 1:30 PM. The training will take place at Wellseed TRC, located at 4701 West Schroeder Dr., Suite 106, Brown Deer, WI 53223.

Important Information:

The class fee is $100. Participants must attend both class sessions to receive certification.

After submitting this form and completing payment, you will receive a training disclosure form that must be signed and returned by the participant(s) and their parent/guardian before the training date.
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student E-mail
example@example.com
Mobile Number
Parent/Guardian Name
Phone Number
Parent Email
example@example.com
Emergency Contact

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Courses
Consent and Agreement

Photography Release: Permission to use photos of the participant for promotional or educational purposes.

Medical Release: Authorization to provide emergency medical care if necessary.

Liability Waiver: Acknowledgment of risk and release of liability for the organizers.

Attendance Requirement: Acknowledgment that both sessions must be attended for certification.
Signature

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Babysitter's Training and Pediatric First Aid/CPR