Individual Registration

Please enter information in the form below to process registration for event Rebooking Fee CPR.

First Name *

Last Name *

Organization

Address *

Address 2

City *

Zip *

State

Phone *

Email *

Comment

Optional class add-ons (Lifeguarding and lifeguarding instructor classes only)

For Registration only

To add a CPR pocket mask set (required for the class)- given on the day of class.

For LGI students who need basic LG cert

For LGI basic LG cert with CPR pocket mask

Coupon

Amount

Discount Amount

Gross Amount

Payment Method *

Paypal Visa, Mastercard, American Express

Billing Zipcode*

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*

By registering for this event, I accept Terms and Conditions

If you know that your registration went through but did not get a confirmation email please contact us at

Admin@breakwateraquatics.com