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CPR / AED PROGRAM

CPR / AED Group Registration Form

Please complete form below to request a group registration for 16 people or more.

Required fields are marked with * below.

Group/Org./Dept. Name *
Contact Name *
Contact Address *
City *
State *
Zip Code *
Contact Phone *
Contact Email *

Number of Participants? *
First preferred date & time *
2nd preferred date & time *

Preferred Location: *
Clark Hall CPR Classroom Other

Type of Course *
BLS for Healthcare Providers BLS for Healthcare Providers w/ First Aid BLS for Healthcare Providers w/ Pediatric First Aid Heartsaver First Aid w/ CPR & AED Heartsaver First Aid w/ CPR & AED (infant & child)

Payment Options:

Cash, check, money order or credit cards will be accepted.
Payable to: R&I Services
You pay in person at the recreation office, 130 Alumni Arena or Clark Hall
Payments must be received 5 business days prior to the class
Payments will not be accepted at the door the day of class

- Bring proof of payment to class with you

Please send your payment to the following address:
CPR / AED Training Center
130 Alumni Arena
Buffalo, NY 14260

Please print this registration form and submit it with payment.

Submitting the registration form does not automatically sign you up for the class of your choice. You will receive an email confirming date/time/location of the class to which you are assigned.

CPR / AED PROGRAM

• Individual Registration Form

• Group Registration Form

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