Registration Form You are registering for: Class NameClass DateDurationStart TimeLocationFree CPR Mask ($10 value) On the day of class, use your phone to check in on Facebook or Yelp and receive a free CPR mask. Certification You will receive the American Heart Association certification card on the day of the class. Valid 2 years. Student InformationConfirmation Notice & ReceiptEmail MeText MeBoth (recommended)Payment Information Visa, Mastercard or Discover. Cardholder does not need to be the student.-- Month --010203040506070809101112Expiration Month-- Year --20192020202120222023202420252026202720282029Expiration YearTotal $ RQI (Resuscitation Quality Improvement)Yes. I understand.Starting in June, we will transition some locations to the American Heart Association VAM (voice assisted manikins) in some locations. During your skills testing, an instructor will not be present. You will perform your skills testing with the VAM and receive the official American Heart Association eCard on the day of your training. More info: www.bayareacpr.org/rqiACLS eLearning CertificateYes. I understand.You must complete this online course, print it out, and bring with you to the skills testing portion of the course. If you do not receive this link within 2 days, call us. If you have already paid for and taken the AHA online course (and only need the skills testing), do not fill out this form, go to this site: bayareacpr.org/skills onlyTerms and ConditionsI agree to the terms and conditions. By clicking submit, you agree that your credit card will be charged and that there are no refunds. However, you can reschedule your appointment for no extra charge two times using the reschedule link. After two reschedules, the charge is $20 to reschedule. Please do not hit the back button or refresh as you will lose all your information.SubmitThank you!We will contact you soon.