COURSE REGISTRATION FORM (please fill out completely).                 Questions? Call us at 973-826-0277
All classes are held at our Garfield, NJ facility, unless otherwise noted.
You will receive further information once you've registered.

Register for an ACLS or PALS class.
Register for an online class / SKILLS TEST.

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All fields in bold are required.
Please enter your information as you would like it to appear on your certification card.
First Name:
Last Name:
Address 1:
Address 2:  
City: State: Zip Code:
Cell Phone Number: Please give your cell phone number if we need to contact you before the class.
Re-enter Email:

Email will be the primary form of communication for class updates and reminders. We will not share your address with anyone.
This form is for SCHEDULED CLASSES ONLY. If you need to register for a SKILLS TEST, click here.
Course: eLearning classes with skills test available by appointment.
More Info
Have you ever taken this or any CPR course in the past?
No Yes -
Why are you taking this class? Any questions or additional comments can be placed here.
Best time to be reached:
How did you hear about or find us? (Google search, Facebook, word of mouth, flier (where was it posted?), etc.)

Before continuing, ensure all the information is filled out and correct.

Before submitting this form and registering for a class, you must agree to the following:
(1) show up at the scheduled date and time;
(2) pay the course fee due by the time of the class in the form of cash or check, or pay with credit/debit card on next page;
(3) you have read our cancellation policies;
(4) all of the information provided above is correct to the best of your knowledge.

I have read and agree to the above terms.
You must click the checkbox indicating you agree to the terms before you can submit your registration form.

Please enter the above words to prove you are human!
If you are asked to re-enter, you may need to uncheck and recheck the checkbox above.
Having trouble? Call us at 973-826-0277!

Training Courses:
Basic Life Support (BLS) for Healthcare Providers
CPR, AED, & First Aid
CPR/AED for Personal Trainers
Which class should I take?
Online Classes / Skills Tests
On-Site Training for Home or Office
Family & Friends CPR Anytime
CPR Equipment:
CPR Supplies
First Aid Kits
Personal Life-Safety Monitoring Systems
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Contact Us
Pay for your class
Reviews & Testimonials
Class Photos
American Heart Association Authorized Provider of CPR & ECC Courses
Logo Design by Lisa Bednarz
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