American Red Cross Training

To register for an American Red Cross training please fill out this form. You will be contacted back via email with additional information.

<form-template>
	<fields>
		<field type="text" subtype="text" required="true" label="Name" class="form-control text-input" name="text-1704908761565"></field>
		<field type="text" subtype="text" required="true" label="Email Address" class="form-control text-input" name="text-1704908769404"></field>
		<field type="text" subtype="text" required="true" label="Phone Number" class="form-control text-input" name="text-1704908781210"></field>
		<field type="date" label="Date Field" class="form-control calendar" name="date-1704909269480"></field>
		<field type="checkbox-group" required="true" label="Certification Needed" description="Please check the course you would like to attend." class="checkbox-group" name="checkbox-group-1704908829196">
			<option value="Adult CPR/AED &amp; First Aid" selected="true">Adult CPR/AED &amp; First Aid</option>
			<option value="Adult &amp; Pediatric CPR/AED &amp; First Aidn-2">Adult &amp; Pediatric CPR/AED &amp; First Aid</option>
			<option value="BLS/CPR for the Professional Rescuer">BLS/CPR for the Professional Rescuer</option>
			<option value="Lifeguarding">Lifeguarding</option>
		</field>
		<field type="radio-group" label="Currently, I am" class="radio-group" name="radio-group-1704908965354">
			<option value="Certified, but expiring soon" selected="true">Certified, but expiring soon</option>
			<option value="Expired, but only by a couple months">Expired, but only by a couple months</option>
			<option value="Expired by more than 3 months">Expired by more than 3 months</option>
			<option value="taking this class for the first time">taking this class for the first time</option>
		</field>
		<field type="date" label="Which class date are your registering for?" class="form-control calendar" name="date-1704909272624"></field>
		<field type="textarea" label="Use this space to ask any questions, or to provide any additional information." class="form-control text-area" name="textarea-1704909305495"></field>
	</fields>
</form-template>

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