Pet First Aid Registration Form Please fill out a separate registration form for each person who will be participating in the course. An invoice will be emailed with payment details within 48 hours of registration. Payment must be made in full to participate in the class. Questions? Email: firstname.lastname@example.org Name* First Last Email* Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country How did you hear about this course?*Select all that apply Select All I am a client of Critter Sitters & More Facebook Feed or Group Work Rescue/Shelter* Event Calendar - Online or Printed I you were referred to this course though a rescue or shelter, please list them here:Are you currently in the pet care/service industry? Groomer Pet Sitter Boarding/Doggy Day Care Vet Office Shelter/Rescue Other What pets are currently apart of your family?*Please provide Name, Species, and Age.Have your any of your pet(s) ever experienced an emergency?*This could be any that you have cared for. Yes No If you answered YES to the question above, please share some details.Select your Pet First Aid Class!Class are 6 hours in length including breaks. Participants will need to bring a stuffed animal to practice bandaging*, rescue breathing and figure 8 harnesses*. *Provided in class materials kit Select Your Class Dates*Wednesday Nights, 7-9pm (3) - 2 Hour Classes May 19, May 26, June 2nd)Saturday June 5th, 1pm - 7pm - IN PERSON - Just Say K9 Sports Pet First Aid Course- Training Class*Class includes: 2 Pocket Guides: either Dog OR Cat (Want Both? Purchase the other set for only $12), items needed for the hands on portion, 6 hours of instruction certificate of class completion, and an invitation to participate in a monthly meetings to enhance skills. Persons in the pet services profession will receive a badge upon request to display on their website and for use on social media. *Your will select your pocket guide preference below. Price: $75.00 Quantity: Pocket Guide Selection*1 set of pocket guides (either cat or dog) is included in your registration. The other set can be purchased for only $12.00Dog Pocket GuidesCat Pocket GuidesDog and Cat Pocket GuidesTotal $0.00 Discount CodeEnter code here. Discount will be applied on your emailed invoice.