Girl Scouts - Great Rivers Council

First name:
Last name:
Home Phone:
Work Phone:
Street address:
Address (cont.):
City:
State:	Zip Code:
Is this a new address:	Yes No
Girl Scout Position:
Troop Number:
Age Level:
Service Unit # & Name:
E-mail (required for online First Aid & Cookie Manager Training):
	Course ID:
Course Date:	Course Time:
Location:
Comments:

Please submit a separate form to register for each class and register at least 14 days prior to the date of the course to ensure prompt confirmation.

IF A FEE IS REQUIRED, EITHER PRINT THIS FORM AND MAIL IT TO GIRL SCOUTS OF WESTERN OHIO - GREAT RIVERS REGION OR ENTER CREDIT CARD INFO.

Credit Card #: Exp. Date: Amount Enclosed $

Fee Listing

Basic Camp Certification - $10

Standard First Aid with Child CPR - $19.00*

CPR Review - $19.00*

CPR/AED for the Professional Rescuer - $19.00*

Online First Aid/Adult CPR - $19*

*The cost of these courses are for the online training only.
If you have the most current American Red Cross First Aid and CPR Participant’s Manual entitled: First Aid/CPR/AED for Schools and Community copyrighted 1996 by The American National Red Cross, the cost of any of the courses is $3.50.

All other classes are free.

To cancel a training registration, please call Girl Scouts - Great Rivers Council at (513)489-1025 or (800)537-6241.

Submission of this form is only a request to register for a training. You are not registered for a course until you receive your confirmation. Your confirmation will come via e-mail to the address listed above. Please make sure to check your e-mail for confirmation prior to coming to the training.