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Person Taking this Course: Registrant's Name(Required)

First Last

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email: This email will be used as the default email to send you your modules through the Canadian Red Cross(Required)

Your confirmation/receipt will also go to this email. Please check your junk folder in the event that the confirmation/receipt does not enter into your inbox. Within the week prior to your course start date, modules will be assigned to you through the Red Cross. Ensure you check your junk folder, for the log in information, to access and complete the modules before the course start date.

When the Red Cross issues you your modules they will send you an email prompting you to set up a Red Cross account. You will complete your modules in My Profile—My Online courses. To access your certificate a few days after the course please use this link: Access Your Red Cross Account.

Your Red Cross account is defined by your name and email that you use to create your account. You become the account holder. If you use your account to register someone into this course, or are using someone else’s account to register into this course, your certificate will be in the account holder’s name. The Red Cross does not allow for account sharing. To receive a certificate in your name, you must create a Red Cross account in your name using your personal email (this cannot be shared) to receive a individually specific certificate that identifies you as the certificate holder.

What email will you or did you use to create your Red Cross Account?

Optional: This section is for Breath for Life's records. No email or correspondence will be sent based on the information entered.

Provide Your Company Details

Breath for Life is required to keep on file a record of all registrants: no longer than 5 years. By entering company information this will be an additional way to search for registrants if certification information is requested.

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Company Name

Company Contact:

First Last

Company Email

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I understand that I will be provided with a digital version of the First Aid and CPR book (e-book). I would sooner have a hard copy of the manual for an extra $25.00(Required)

Yes, I will purchase the hard copy of the First Aid book

No, I am satisfied with the digital manual e-book

The digital manual link is found on your confirmation/receipt at the top of the page.

Product: Intermediate First Aid Blended Course

Price:

All first aid courses include CPR and AED.

GST

Price:

Red Cross Manual

Price:

GST

Price:

Total

By entering your name in the space provided, representing either the cardholder and/or the registrant or a person registering on behalf of the registrant whether you are the cardholder or not, or the registrant borrowing someone else’s credit card, you accept the terms and conditions of the policies around your registration into this course. By entering your name in the space provided you are entering into a contract with Breath for Life. As Breath for Life’s goal is to never cancel courses, which you as the registrant would expect when you pay for this course, if you require to step outside of the contract (eg.: reschedule and/or cancel, miss your course, are late, etc ), the terms and conditions of the policies which you agree to will be used to guide decision making, in a fair, consistent and neutral way.(Required)

First Last

I would like to pay for this course.(Required)

Yes

Credit Card(Required)

Level C CPR

Level A CPR

First Aid Book

This field is hidden when viewing the form

Course Selection changelog (hidden field)

CAPTCHA

You must complete the captcha and then press submit. When you press submit you will see a turning circle. This means that your payment is being processed. Please allow time for the processing and do not exit out. This will result in a failed registration. Check your email to ensure you are registered and if you are not you will have to re-register. Do not re-register until you check your email or junk/spam folder if you accidently log out while your registration is processing. Remember your email will go tot he email you provided in this form.

Please be patient while your transaction is being processed. Please allow time for the processing to occur and do not exit out until you receive a successful registration notice. Not waiting for the processing wheel to stop by logging out early will result in a failed registration. Check your email inbox/junk/spam to ensure you are registered and if you are not you will have to re-register.

“First Aid & CPR Training in Edmonton and Area”

Standard (Intermediate) Blended 2-Day Course Form

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Choose Course Date

Important Notice about Being on Time

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CANCELLATION/RESCHEDULING POLICY