StaySafe!-Montroyal Elementary School

Red Cross Stay Safe!

StaySafe!- Montroyal Elementary School
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School (of StaySafe! course) *
Course Date *

Day Month Year
Student Full Name *

Last Name First Name
Address *
City *
Province *
Postal Code *
Area Code *
Phone Number *
Cell Phone Number
Parent(s) First & Last Name *
E-mail *
Emergency Contact Name *
Emergency Phone *
Comments (Allergies, Conditions, etc...)
Declaration - In enrolling my child(ren) in the Red Cross First Aid Hero StaySafe! Course, I understand that the Instructors will take all precautions and pay the utmost attention to safety. However, I understand that accidents can occur and I will not hold them responsible. *

Please check box to accept.
Electronic Signature - You now have the option to sign this form electronically. If you elect to do so, you hereby consent and agree that your use of key pad, mouse or device to click “I Agree” button constitutes your signature, acceptance and agreement to the Declaration section immediately above as if actually signed by you in writing and has the same force and effect as a signature affixed by hand. *

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Payment Method *

Online Cheque - Registration confirmed ONLY with payment. Online preferred. Must be received 7 business days in advance. $65 + $3.25 GST= $68.25 for admininstration. Thank you.
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Red Cross StaySafe! Course (Including GST) $ 63.00 CAD

GST 853610632 RT001 Free

Total $ 0.00 CAD
Please send cheque with student name and school written on the cheque by submission deadline.

Cheque is made payable to Marla Rosen

Send to

PO Box 19111

Vancouver, BC

V6K 4R8

Thank you.
Refund Policy - Full refund within 5 business days accepted, afterwards sorry no refunds.

email: marla@firstaidhero.com www.firstaidhero.com
Please Note

For full time class, please provide a bag-lunch and two big snacks. For part time class, please provide a snack each time. Please also provide plenty of water. Children will not be allowed to leave the premises during breaks and lunch. No nuts please.
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Red Cross Stay Safe!

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