Health & Safety Class Registration Form         
Please Print Clearly

Name:      ________________________________

Address:  _____________________________________

      _____________________________________

Telephone Number:    _______________________________

Which class would you like to attend?  ___________________________________________

PLEASE NOTE:

• Pre-registration and payment is required for all classes.
• If you are enrolled in a class and cannot attend, Red Cross must be notified at least ONE business day in advance or your fee will NOT be refunded.
• If you do not show for a class you will NOT receive a refund.

There must be a minimum of 6 people registered in a course for it to take place.  Therefore, classes are subject to cancellations.  If a class is cancelled, you will be notified and you may reschedule or choose to receive a refund.

Unless otherwise noted, all classes will be taught at:
American Red Cross
414 Breard Street
Monroe, LA 71201
318-323-5141

Please Print This Form and Return With Payment to:
American Red Cross
414 Breard Street
Monroe, LA 71201