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This fun and interactive 12-hour course includes certification for Infant/Child CPR, Pediatric First aid and Home Alone / Babysitting Certification. Candidates must have completed the 6th grade and be at least 12 years old by September 30 to attend this course. Get trained by the experts in health & safety at the Central California Safety Council! Registration: Registration in advance is required, no walk-ins on the day of the class. Enrollment is limited & classes fill quickly, confirmation is on a 1st paid basis. Tuition is not refundable or transferable to a different date. Print and complete the registration form below. If paying more than 2 weeks in advance, payment may be mailed with the registration form below. If openings are available, payments in cash (exact change only) or a money order may be brought into the Safety Council office until noon on Friday, June 10, 2016. Print the registration form below & make checks/money orders payable to: Safety Council, 6004 N. El Dorado St., Stockton, CA 95207-4349. Print Page & Return Registration Form Below With Payment: CLOSED 12pm to 1pm DAILY, for lunch Click Here for Calendar with Weekday Office Closures
Date: M/W/F, June 13, 15, 17, 2016 (attend all three dates) Time: 8:00 am - 12 Noon $75.00 STUDENT INFORMATION Please Print Clearly! Student First & Last Name: ___________________________________________________________
City: ____________________________ State: _______ Zip Code: __________________ Student Phone: ______________________________________ Age on 9/30: ____[ ] Male [ ] FemalePreferred Nickname: ________________________________ Main Reason for Taking Class: ________________________________________________________________________________ Student's School Name: ______________________________________________________________ Payment Type: EMERGENCY CONTACT INFORMATION Emergency Contact Name: ______________________________________ Phone: ___________ Relationship To Student: ______________________________________________________________ Alternate Contact Name: ________________________________________ Phone: ___________ Relationship To Student: ______________________________________________________________ |
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