YORK REGION
First Aid Course Registration Form

(SIGN-UP DEADLINE: Tuesday, February 18th @ 12pm Noon)

Youth Units 829Y & 910Y First Aid Course is being held this year on February 29-March 1. Please complete this form taking care of the spelling of your name as it will appear on your printed First Aid Certificates. Once a year, it is mandatory for our Youth Cadets to participate in our yearly First Aid course which is offered at NO COST to our youth members every year but is the same course offered to the public for $190. A few weeks back we held a vote with our youth members by email to decide which weekend would be selected. The majority of votes selected the February 29 - March 1 date. Here is the course information and details:

COURSE DESCRIPTION:
Standard First Aid CPR C + AED
This two day course is for individuals who require more comprehensive information on first aid and CPR for the workplace, educational institution or personal interest reasons. This course meets Canadian Labour Code and Ontario First Aid Regulation 1101 for workplaces with more than 5 employees. This interactive program includes CPR training for adults, infants and children, 2 person CPR as well as automated external defibrillation (AED). Certificates valid for three years are issued upon successful completion.

COURSE LOCATION:
Richmond Hill Location - Second Floor, First Door on left.

CLASS ADDRESS:
13321 Yonge Street, 2nd Floor Richmond Hill, ON L4E 0K5

DIRECTIONS:
We are located on the East Side of Yonge Street Between King & Bloomington in the TD Plaza. PLEASE DO NOT PARK IN FRONT OF DAYCARE/STORES AND PARKING SPOTS ALONGSIDE TD BANK. CARS WILL BE TOWED!

SCHEDULE:

Day 1
Start Date and Time: 2020-02-29 8:30 AM
End Date and Time: 2020-02-29 5:30 PM

Day 2
Start Date and Time: 2020-03-01 8:30 AM
End Date and Time: 2020-03-01 4:30 PM

LUNCH / SNACKS:
Please bring lunch, snacks and bottle of water for both days.

PLEASE NOTE:

CLASS START TIME! ATTENDEES WHO ARE A HALF HOUR LATE OR MORE WILL NOT BE ACCEPTED INTO CLASS.

During the winter months outdoor footwear is not permitted in our training rooms. Please bring additional footwear or use the slippers provided.

Thank you!

I am registering my SON / DAUGHTER to attend the St. John Ambulance York Region Cadet Youth Program First Aid Class and I am the legal Parent / Guardian, over the age of 18+, responsible for the person being named in this Application Form -OR- I have reached the age of 18 -OR- I am 16-17 years of age NOT residing with a Parent/Guardian. By Clicking "Acknowledge" you hereby state this information as being true.

Are you OVER the age of 18 years?
(Participants under 18 years old requires Parental / Guardian permission)

*

Acknowledge - I am a Parent / Guardian

Acknowledge - I am over the age of 18+

Acknowledge - I am 16-17 years of age NOT residing with a Parent / Guardian

BRANCH UNIT

What is Your Youth Unit #?: *

UNIT #829Y (North Richmond Hill - Home Branch)

Unit #910Y (Newmarket / Aurora)

PARTICIPANTS INFORMATION

FIRST Name: *

LAST Name: *

Preferred Name / Goes By: *

Birthday: (Day/Month/Year) * +

Age Today?: *

Language Preference: *

ENGLISH

FRENCH

HOME Phone #: *

CELL Phone #:

Home Address: *

City: *

Postal: *

Province:

Participant E-MAIL Address: *

Want to keep connected with St. John Ambulance? Our E-mail Updates.

PARENT / GUARDIAN

CONTACT #1

#1 Parent/Guardian FIRST Name: *

#1 Parent/Guardian LAST Name *

#1 Parent/Guardian HOME Telephone #

#1 Parent/Guardian CELL Telephone # *

#1 Parent/Guardian E-MAIL Address *

CONTACT #2

#2 Parent/Guardian FIRST Name:

#2 Parent/Guardian LAST Name

#2 Parent/Guardian HOME Telephone #

#2 Parent/Guardian CELL Telephone #

#2 Parent/Guardian E-MAIL Address

EMERGENCY CONTACT

#3 Emergency FIRST Name: *

#3 Emergency LAST Name *

#3 Emergency HOME Telephone #

#3 Emergency CELL Telephone # *

Receive TXT messages? *

YES

NO

Thank You!

Upon pressing the SUBMIT button below, you will be emailed a copy of all your registration responses and your registration will be forwarded to your Unit Coordinator.

YORK REGIONFirst Aid Course Registration Form

YORK REGION
First Aid Course Registration Form