Become a Certified Child Passenger Safety Technician at this volunteer training. 4 out of 5 car seat are installed incorrectly.
National Standardized Child Passenger Safety Technician Training Course
August 25 & 26 and September 1 & 2, 2009
Name: ____________________________________ Title: _______________________
Agency/Department: ______________________________________________________
Address: _______________________________________________________________
City: _____________________________ State: ____________ Zip: _______________
Telephone (Work): ______________________ (Home): __________________________
Fax: ________________________________ E-mail: ___________________________
Participants must attend the entire time.
Kids Worldwide and $85.00 payable to Safe Kids Greater Cleveland. Breakfast and lunch will be provided each day. Class size is limited. The course fee is $145.00: $60.00 payable to SafeTo guarantee a space you must be registered with SKW. Registration is a two part process. You must first register with SKW at www.safekids.org/certification. If you are having difficulty, contact the Safe Kids help line at (877) 366-8154. After registering with SKW, send this form with the $85.00 fee paid by check, PO or credit card to the address below. Note to employer: Since we can accommodate only a limited number of students, we need confirmation that you understand and agree that the prospective student listed below will be at class from 8:00 am to 4:30 pm each day and that he/she will not be available to return telephone calls or pages except during breaks.
Signature/title of Supervisor______________________________________________
Signature of Student___________________________________________________
For questions contact Tom Vilt at 216-983-1115 or thomas.vilt@UHhospitals.org
Send this form and payment to: Rainbow Injury Prevention Center
10524 Euclid Ave. WLK 3024
Cleveland, OH 44106-6039
Attn: Tom Viltmay find these activities difficult.www.safekids.org/certification. Registration can be completed on-line if paying by credit card.address listed on web site. do not send the $60 SKW fee to SKGC. The total cost of the class is $145.00: $60.00 payable and sent to Safe Kids Worldwide and $85.00 payable to Safe Kids Greater Cleveland. The attached SKGC form should be completed and returned along with the course fee. Payment to SKGC can be made by check, purchase order or credit card. Mail the completed SKGC form with payment to: Rainbow Injury Prevention CenterAttn: Tom ViltIf you have any questions please contact Tom Vilt / CPS Coordinator at 216-983-1115 or thomas.vilt@UHhospitals.org
Items you should consider before registering for the class are:
* The class is scheduled from 8:00 A.M. to 4:30 P.M. each day (August 25 & 26 and September 1 & 2, 2009). Attendance for the entireclass time is mandatory. No exceptions can be made.
* The class requires some moderate physical activity including lifting, pulling and climbingin and out of the back seat of vehicles. Those with limited mobility, back or knee problems
* Participants must engage in a moderate amount of reading, and pass both hands-on and written exams to successfully complete the course.
* Most of the hands-on activities will be conducted outdoors. Please dress appropriately for the weather conditions.
* Students’ vehicles will be used for hands-on activities.
* Class size is limited. You must be registered with Safe Kids Worldwide to guarantee a space in the class.