Sun & Surf Lifeguard Training Registration

1
Name* This field is required.
First Name
Last Name
2
Address* This field is required.Start in the line below and it will auto-fill. Please Include House number street, city, state and zip
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
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Nigeria
Niue
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Portugal
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Saint Helena
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Country
3
Your Email* This field is required.This is necessary, the Red Cross uses this to identify you.
example@example.com
4
Parent Email(If you are under 18 years old.)
example@example.com
5
Your Phone Number* This field is required.Cell Phone
Area Code
Phone Number
6
Where did you hear about us?
Rock Sports Club
Internet
Sun & Surf web page
Red Cross Web page
Facebook
Instagram
School
Friend
Other
7
If you are under 18 years of agePlease put a parent or guardian phone number.
Area Code
Phone Number
8
If a friend who? If school, which school? Please give us any additional details.
9
Will you be 15 years old before the last day of the session you enrolled?* This field is required.If you are not 15 years of age before the last day of the course you cannot register for that session.
YESNO
10
Which Session do you want to register to attend?* This field is required.Pre-Skills Test will be approximately 1 hour. Each session is scheduled as follows: Sundays: 9:00 Am to 3:00 pm. Some classes may end early or run late depending upon class size and ability.
February Full-Cert Class Pre-skills Test: Sat 2/5 @ 1pm sharp. Classes 1pm-6pm: 2/5, 2/12, 2/19, 2/26.
April-May Full Cert Class - Pre-skills Test: Sun 4/24 @ 11am sharp. Classes 11am-4pm: 4/24, 5/1, 5/15, 5/22.
11
Will you be able to attend all sessions of the course?If you cannot attend all session, you cannot take the course.
YESNO
12
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