Registration Form

You are registering for:

Class Name

Class Date

Duration

Start Time

Location

Free 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 Information

Confirmation Notice & Receipt

Email Me

Text Me

Both (recommended)

Payment Information

Visa, Mastercard or Discover. Cardholder does not need to be the student.

Expiration Month

Expiration Year

Total

$

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/rqi

ACLS eLearning Certificate

Yes. 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 only

Terms and Conditions

I 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.

Submit

Thank you!

We will contact you soon.