Red Cross/AHA Registration | Saint Joseph's College of Maine

Red Cross/American Heart Association Registration

Mail Payments to:
Renee Daigle, Alfond Center
Saint Joseph's College
278 Whites Bridge Road
Standish ME 04084

Participant's First Name: *

Last Name: *

Date of Birth: *

MM|DD|YY

Course: *

Please identify any medical, behavioral, or physical conditions our staff should be aware of:

Parent/Guardian Name (if applicable):

Primary Phone Number: *

Email: *

Mailing Address: *

City: *

State: *

Zip Code: *

Waiver: *

Yes

The undersigned hereby releases and holds harmless Saint Joseph’s College, the Alfond Center and its employees from and against any and all suits, actions, and damage arising out of, connected with or resulting from participation from this program/event sponsored by Saint Joseph’s College.

Electronic Signature: *

Participant, or parent/guardian if under 18, type in your full name here.

Comments:

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Red Cross/American Heart Association Registration

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