HIGH FIVE^® Training Request Form


This form should only be completed by an organization interested in hosting a HIGH FIVE training. An asterisk (*) indicates a mandatory field.

STEPS:

Workshop Type Selection

Host Organization

Training Location

Training Materials Mailing Information

Training Session Information

*Format:

*Training Name:

*Would you like to receive Aquatic PHCD Workbook:

Yes

*Language:

English

French

*Date of Training (mm-dd-yyyy):

What is the start and end time of your training?

*Number of Learners: (12-25)

*Number of Training Packages: (0-25)

Check this box if the number of training packages is different than the number of learners.

*Learner Type:

(staff, instructors, lifeguards, coaches)

*Would you like HIGH FIVE to arrange a Trainer for you?

Yes

Trainer: Please select the Trainer that will be conducting your HIGH FIVE training from the dropdown list below. Please note you are responsible to confirm all training details with this Trainer.
Lead Trainer:	(optional)
Trainer2:	(optional)
Trainer3:	(optional)

*Is your HIGH FIVE training open to the public?

Yes

What are you charging each learner?

Is Lunch Included in the course fee?

Yes

Contact for registration or more information
	Name:
	Phone Number:
	Email:
		Provide the link for participants to register for your training:
	URL (Link):
	Access to Parking & Cost to Park::
	Additional Information:

Contact Person During Training: (An individual who could help a learner get the information needed to attend the training)
	Name:
	Email:
	Phone Number:	This contact will be available for same day assistance.

Additional Information/Comments for HIGH FIVE

HIGH FIVE® Training Request Form