CPR Class Registration

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This form is to request registration for an upcoming AHA HeartSaver CPR provider class. By completing this form, I understand that a class will not be held until a certain number of participants is reached.

Visit: Heartsaver® CPR AED Training | American Heart Association CPR & First Aid for more information about this course.

Call: 573-238-2817 and request Erin for any other questions

Name *

Age *

Phone Number *

Email Address *

Mailing Address

County of Residence

Type of CPR Class Requested *

Heartsaver-non-medical staff

Basic Life Support-for those who work in the medical field

Child Care required training

School personnel requesting training

Business requesting training for all staff (if over 12 individuals, please call BCHC directly)

I understand that I will be contacted either via email or phone call when a class is scheduled. I also understand that there is a $22 cost for the CPR certification. *

Yes

Required

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