2019 Bronze Medallion and Bronze Cross Lifesaving Registration Form
* Available to pool members only

*Registration will be complete upon payment and submission of prerequisite photocopies (as indicated below)

Prerequisites
Bronze Medallion Prerequisites:
(1) min. 13 yrs. old OR hold Bronze Star certification
(2) completed Red Cross Swim Kids 10, Olympic Way Silver, or equivalent
(3) must provide a photocopy of my certification card (Bronze Star) OR photocopy of my Medicare card/Gov’t ID as proof of age (to be provided at a later time)
(4) must pay the $55 course fee

Bronze Cross Prerequisites:
(1) Bronze Medallion
(2) must provide a photocopy of my Bronze Medallion certification card
(3) must pay the $55 course fee

Membership Family Name *
Your answer
Last Name (if different from Membership Family Name above)
Your answer
First Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Full Address (including postal code) *
Your answer
Email Address
Your answer
Phone Number *
Your answer
Bronze Medallion *
Bronze Cross *
Please check below if you like to order the Canadian Lifesaving Manual *
Please indicate your method of payment *
IMPORTANT NOTE FOR BRONZE PARTICIPANTS:
Required Materials for the Bronze Medallion and Bronze Cross Courses:
-Pocket Folder for printouts
-Pencil/Pen & Notebook for written notes
-Pocket Mask (available at Diffusion Aquasport in Pointe-Claire – mention the summer pool discount)
-Canadian Lifesaving Manual (available through Beacon Hill Pool – an additional $45 fee. Indicate by checking off the box above)

Please note that 100% attendance is encouraged, and that students missing classes put themselves at risk of failure. The final class is mandatory.

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