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Registration Form Instructions - Please Read and fill out all required sections.

Note-For Addresses we require BOTH Street Address and PO Boxes.
Note-A CDN Number is Only required for Transport Canada Marine First Aid Courses
Note- Before Completing the last 4 sections and checking the confirmation boxes, take the time to read the policies on the main webpage under the page "Courses-Safety Info, Liability Waiver, Refund Policy

Name (First and Last) *

Date of Birth (Day/Month/Year) *

Telephone Number *

Email address *

PO Box *

Country *

Street Address *

Town/City *

Province/State *

Course Name *

Radio- ROC-MC- 3 day
Radio- ROC-M- 1 Day
First Aid- Basic(Emergency- 1 day)
First Aid- Intermediate(Standard- 2 Day)
First Aid- Marine Basic (2 Day)
First Aid- Marine Advanced (4 Day)

CDN Number(Transport Canada -Marine First Aid Courses ONLY)

Postal Code/ZIP Code *

Emergency Contact- Name *

Liability Waiver- Please read and check the box to acknowledge you read and understood the information *

I have read and understand the Liability Waiver and agree to its terms

Emergency Contact Phone Number *

Safety Information - Please Read *

I have read and understand the Safety Information Section and agree to its terms

Emergency Contact- Relationship *

Spouse
Friend
Partner
Daughter
Son
Father
Mother
Other

Payments- Once the form is received and reviewed an Invoice will be emailed to the email provided with instructions for payment. Only after the payment is confirmed will the seat be considered booked

Multiple seat booking- If you wish multiple seats booked enter the names and email addresses of the individuals below

Leave this field empty