CPR Registration Form

This course includes ASHI First Aid, CPR and AED student book, pocket CPR mask, and certification card.

Cards will be emailed the week following class.

Class Location:

Heller Fire Station 25

2720 Heller Road, Oak Harbor, WA 98277

Class Time:

8:00 a.m. - 2:00 p.m. (suggest bringing a snack and water)

Course Fee:

$50 (plus 3% card service fee if paid by credit/debit)

First name

Last name

Phone

Email

Country/Region

Address

City

Zip / Postal code

Preferred Course Date:

I understand that my payment of $50 is non-refundable. If I cannot attend my scheduled class, my payment may be credited towards a future CPR course to be used within 3 months.

Please call 360-675-1131 or email cpr@nwfr.org for any questions.

Signature

Date: