AHA BLS - Class Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

The information gathered in this form is used to submit a roster to the Training Center for your CPR card.

Course Date *

First Name *

Last Name *

Email Address *

Telephone Number (No symbols) *

Organization/Agency

You verified the above name, telephone, and email are accurate. A $10 change fee is required should you have to modify the information needed to receive your eCard. The fee applies only after the instructor has submitted the roster to the training center for issuance of the eCard. This fee goes to the training center, not to the instructors.
*

I understand

Once you pass this course, your CPR card will come in the form of an email. Physical paper cards are no longer issued. You must follow the instructions in the email to claim the digital version of the card known as an eCard. You understand that the email may come to your inbox, spam or junk folder. You must check these locations to verify the email was received or not received. The email will come directly from the American Heart Association. If you do not follow the process in the email, your eCard will remain unclaimed. There is no charge to claim your eCard. You understand that by following this claim process you will have access to the eCard as many times as needed. You access your eCard by going to https://ecards.heart.org/student/myecards. It may take up to 10 days for your eCard to arrive in your email.
*

I understand

The training center may take up to 10 days to process training rosters. Should you not receive an email regarding your card after that time, communicate with our CPR training instructors at bhanzal@stoneypointfirerescue.com or cstewart@stoneypointfirerescue.com. *

I understand

I understand that as an individual not associated with a fire department/government agency, the course tuition is $40.00. This is payable to the instructor before the end of the course. Cash only unless the instructor makes other arrangements.
*

I understand.

I understand. I am a member at Stoney Point Fire Department.

I understand. I am a member of a fire department, EMS agency or other government agency.

FOR STONEY POINT FIRE DEPARTMENT MEMBERSHIP ONLY: I understand that it is my responsibility to turn in proof of my CPR Card either in hard copy form into the Training box in the Station 13 or 19 Radio Room or email it to tgarris@stoneypointfirerescue.com in order to get credit for this class.
*

I understand

I am not a member at Stoney Point Fire Department.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Stoney Point Fire Department. Report Abuse

Forms