Please fill in the information below. Pre-registration and payment are required to successfully register for this course. Upon submission of this form, you will be able to pay the course fee online. A confirmation notice will be sent when your registration form and payment are received. The fee for the course is $110.00 per person and must be received to confirm your participation in the class. PLEASE BRING A PAYPAL PAYMENT RECEIPT OR SCREEN SHOT WITH YOU TO THE WILDERNESS FIRST AID CLASS AS PROOF OF PAYMENT FOR THE INSTRUCTOR. Thank you.

Name:
E-Mail:
Address:
City:
State:
Zip:
County:
Home Phone:
Contact me by: Phone
Email
Mail
Do You Have CertificationsI Do Do Not Have Previous First Aid Certification.
Expiration Date:
I Do Do Not Have Previous CPR Certification.
Expiration Date:
Additional Comments or Requests?:

 

Thank You for submitting a NYSOGA Outdoor Training Course Registration Form.

NYSOGA Guides
NYSOGA New York State Outdoor Guide Association
1936 Saranac Avenue, Suite 2 - 150, Lake Placid, NY 12946
1-866-4NYSOGA (1-866-469-7642)  · 
E-Mail: info@nysoga.org  ·  Web Site: www.nysoga.org
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