Wilderness First Aid Registration (12/14)

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Please fill out this form even if you have filled out previous Sage registrations. It is the best way for us to contact you in an efficient manner. This course is open to the Sage community, as well as the general public.

This form does not reserve you a space in the course. Only paying the full amount of tuition reserves your spot. See website for directions on how to pay.

Participant First Name *

Participant Last Name *

Participant Email Address (Please spell carefully!) *

Participant (or Parent) Phone Number *

Are you a minor? *

Yes

If yes, please provide your parent's Full name

If yes, please provide your parent's email address

Are you taking this course to recertify your Wilderness First Responder (WFR)? To recertify on this course, NOLS must be your last recertifying agency. *

Yes

If yes, what organization certified you?

If yes, what is the expiration date on your card?

Please submit the following to the front desk at Sage or mail in: *

For general public, $235 cash or check payable to "Sage International School" with "WFA" and your name in the For line

For Sage family and friends, $175 cash or check payable to "Sage International School" with "WFA" and your or your students name in the For line

For Sage students, $100 cash or check payable to "Sage International School" with "WFA" and your students name in the For line

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