Wilderness First Aid Course Registration

Wilderness First Aid Course Registration — Form Fields

This applications template includes 10 fields. Register for wilderness first aid certification courses with experience level and schedule. Free to customize and use on ZenBuild.

• Full Name (text, required)
• Email Address (email, required)
• Phone Number (text, required)
• Course Level (dropdown selection, required) — options: Wilderness First Aid (WFA 16hr), Wilderness First Responder (WFR 70hr), Wilderness EMT, WAFA (2-day awareness)
• Current Certifications (dropdown selection, required) — options: None, CPR/AED, Standard First Aid, EMT, Paramedic, Other
• Reason for Taking Course (dropdown selection, required) — options: Personal Hiking/Camping, Professional Guide, Military/Search & Rescue, School Requirement, Other
• Course Date Preference (text, required)
• Any medical conditions that may affect participation? (dropdown selection, required) — options: No, Yes (will contact you)
• Emergency Contact Name & Phone (text, required)
• Special Accommodation Needs (long text, optional)