I am interested in taking the Skills Evaluation Session with Breath for Life*
- Yes
- No, I have passed the Skills Session and want to Register into the online and in-class sessions
Passing a Standard First Aid course does not mean you have passed the Skills Evaluation Session.
Please email breathforlifeinc@shaw.ca your signed off skills check list and your intent to register into the next steps of the instructor course.
Please tell us why you would like to be a Red Cross Instructor*
Please Provide your Date of Birth*
Month
Day
Year

You must be 18 years of age or older to take this course.
I confirm that I have reviewed the Breath for Life web page and understand that the Instructor Course is a 5 step process (4 steps if you are a transfer student)*
- Yes
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I have a current Standard First Aid/CPR Level C*
- Yes
- No
Current means that you have taken the course within one year of the Skills Evaluation Session date. Of importance is demonstrating skill proficiency. Your certificates will be reviewed on the Skill Evaluation Session day.
You must be current, within one year to take this course. Please book into the Standard First Aid Renewal course: Click Here.
Please enter the expiry date of the current Certificate.*
Month
Day
Year
Please let us know the agency where you took your Standard First Aid course. Include whether this is a Red Cross, St. John's, etc. provider.*
The pre-requisite for the Instructor's Course is a Standard First Aid/CPR Level C or BLS Provider. You do not qualify for this course unless you fulfill this requirement.
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Registrant's Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Enter Email Confirm Email

This email will be used to send you the course information and receipt. Please also check your spam or junk folder if the email does not appear in your inbox.
Registrant's Email: You are required to provide an email that will be used to set up your Red Cross account (if you do not have an account). This email must be yours and not shared by anyone else and if different from the email above please enter it in the space provided.
Optional:
- Provide Your Company Details
Company Name*
Company Contact*
First Last
Company Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Company Phone Number*
Company Email*
Skill Evaluation Session ($200 + GST)
Price:
When you have successfully completed your Skill Evaluation Session, you will be required to pay $600.00 plus tax for Steps 2 and 3.
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

Policies
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.*
- Yes
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
By entering your name in the space provided you acknowledge that you have read, understand and agree to the specified policies. I also understand and accept that the purchase of this course will appear as Breath for Life Inc on my credit card statement and that the amount that will appear on my credit card will not be contested as a fraudulent charge.*

By entering your name you are accepting the policies, terms and conditions of this purchase.
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Instructor Course
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By activating the CAPTCHA, you attest to having read and understand the extent of the policies. You must complete the CAPTCHA for your transaction to be processed. Please allow the transaction to process when you press submit. Do not leave this site until you will receive a notice that the transaction was successful. Thank you.
Please be patient while your transaction is being processed. Do not exit until you receive a thank you notice.

“First Aid & CPR Training in Edmonton and Area”

Instructor Course Registration Form

Step 1 of 3

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CANCELLATION/RESCHEDULING POLICY