Coconut Creek Fire Rescue
CPR Class Registration Form

This class is an American Heart Association "Heart Saver CPR". This class includes: Infant, Child & Adult CPR and Defibrillator (AED) Training. This certification does NOT meet the requirements for health care professionals.

Location: Recreation Complex, 4455 Sol Press Blvd., Coconut Creek, Florida 33073 [ see map ]

Fees & Proof of Residency: Free for city residents. Residents must bring valid Drivers License showing City address.

Free for resident full time students. Students from 14-18 years old must bring school photo id and utility bill showing City address.

Free for people who are employed by businesses in Coconut Creek with employment documentation: pay stub or letter from employer on company letterhead and company address.

$25.00 for non residents.

$15.00 for non resident students age 14 to 18 years old.

Time: 6:30PM-10:00PM

Registration fees are non-refundable.

Name:*
Address:*
City:*
Zip:*
E-mail Address:
Phone Number:*
Resident of Coconut Creek?*	Yes No
Employed by a Business in Coconut Creek?*	Yes No
Age:*	14-18 Over 18
Current Available Classes:*	Thu, September 4    (09-04-2008)         (Currently Enrolled = 8) Thu, October 2    (10-02-2008)         (Currently Enrolled = 0) *** Upcoming Classes *** Thu, November 6    (11-06-2008) Thu, December 4    (12-04-2008)
*=Required Fields
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