Student Registration - RESCUETECHS, LLC.

First Name

Middle Initial / Name

Last Name

Date of Birth

It is easiest to select your year of birth first.

Department / Agency Affiliation:

Phone

Email

Confirm Email

Please note that we only ask for your email address to communicate with you specifically regarding the class that you are attending. RescueTechs does not share, sell, etc. your email address to anyone outside of our business. (We hate spam, too!!!)

Address

City

State

PA County

NY County

NJ County

VA County

County

Zip Code

Program you are registering for:

Please carefully select the program you are attending.

Date of Class (1st Day of class if multiple days)

Are you a PA emergency medical services provider (EMR, EMT, etc.)?

Many RescueTechs programs, but not all, are approved for PA EMS continuing education credits. Your instructor will let you know if this program has EMS approved con-ed credits assigned. If this program does have credits, they will be uploaded to the EMS database with 10 days of successful completion of the program.

What is your certification level?

EMR
EMT
AEMT, Paramedic, PHRN, etc.

What is your certification number?

By initialing below, I certify that I am a bona-fide member of my agency/department and is covered by workman’s compensation and liability coverage by this agency. RescueTechs LLC, the program instructors, and the host agency (if other than my own) assume no liability for injuries or deaths that occur as part of this training program. Please initial in the text field below to acknowledge.

Student Initials

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