Heart and Stroke BLS Provider Renewal Form

Step 1 of 4

I understand that masks are not mandatory. However if you are ill presenting with a cough and intend on attending your course you will be required to wear a mask. Breath for Life will supply masks as required.*
- Yes
To qualify for this course you must be an experienced healthcare provider who performs BLS/CPR on a regular basis within your professional career. Taking this course yearly, without performing CPR within your career does not qualify you for this course. As this course is a fast paced, hands on demonstration of skills, which is different from the 4 hour course which teaches BLS skills, proficiency at skill demonstration is key to your success in this course. If you do not fulfill this criteria, please click on the link provided to take the 4 hour course Click Here.

Registrant Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Email*

This email will be used to send your confirmation/receipt
Registrant's Email: This email is either associated with my Heart and Stroke account or I want my Heart and Stroke account to be created using this email.*

Please re-enter your email. If you have a Heart and Stroke account attached to your H&S ID please enter that email here. If you are new to the Heart and Stroke, please provide an email that will be used to create your Heart and Stroke account. An account will be set up for you when you attend the course. For Heart and Stroke account holders: Please ensure that the email associated with your Heart and Stroke ID is current and active. Please ensure that you can log into your Heart and Stroke account and the information is up to date. Breath for Life will not be held responsible for updating your account so if needed please contact the Heart and Stroke for any changes that need to be made PRIOR to the course by calling Toll-Free 1 877 473 0333
I am interested in purchasing a BLS manual (Manual purchase is final sale)*
- Yes (Total course cost: $95+GST)
- No (Total course cost: $75+GST)
To claim your book please let us know that you purchased a book by showing us your confirmation/receipt at the course and a book will be given to you.
Heart and Stroke BLS Provider Renewal Course without manual ($75+GST)
Price:
Heart and Stroke BLS Provider Renewal Course + BLS manual ($95+GST)
Price:
Total
$ 0.00 CAD
Please Note:

Payment must be received in advance to attend this course. Provide debit or credit card information in the payment section below and click on the submit button to complete your registration and payment.
CANCELLATION/RESCHEDULING POLICY
1. This course is final sale.
2. You must arrive to this course on time. Due to the short duration of this course any late arrivals will be turned away. You will be required to rebook into another course at full fee. No refunds will be issued.
3. Please ensure that your registration is correct. If your certificate is expired you will not be allowed to take the course and will lose your registration fee.
Breath for Life Does Not Cancel scheduled courses that you commit to. Breath for Life would like to thank you for your patronage.
I have read and understand the policies.*
- Yes
By entering your name in the space provided, which represents your signature for yourself or someone else, you accept the terms and conditions of the policies which form a contract between you (the registrant) and Breath for Life. If you require to step outside of the contract, the policies will be applied with consistency and neutrality.*

Please note that these policies are meant to be applied to everyone fairly and impartially if the terms of the contract are called into question or challenged.
I Would Like to Pay for this Course*
- Yes
I accept that the purchase of this course will appear as Breath for Life Inc on your credit card statement and that the amount that will appear on your credit card will not be contested as a fraudulent charge (this also applies if you are registering someone else into this course).*
- Yes
Credit Card
Card Details
Cardholder Name
Hidden
Renewal Course Title
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Heart and Stroke BLS Provider Renewal Form

Step 1 of 4

CANCELLATION/RESCHEDULING POLICY