Registration Submission Form

Please fillout and submit the following form for registration. Please bring payment of $250 for Lifeguard Blended Learning Classes, $190.00 for Lifeguard Review Class, or $475.00 for Lifeguard Instructor Classes (make checks payable to: AquaMed) with you on your first day of training.

PLEASE CHECK WHICH CLASS DATE YOU ARE REGISTERING FOR!
Check ONE and ONLY ONE Class Date. Thank you!