Request on-site first aid training

This form allows you to request a date and time for your sports club to hold a first aid training.

"*" indicates required fields

Old Stars Sports Club

Name*

Address*

Street + house number Location Postal code

Contact training:

Name*

First name Surname

Email address*

Phone*

Life-saving and first aid training for athletic seniors:

Desired date*

Bye

Month

Year

Desired start time*

Training lasts 3 hours, please indicate start time

Hours

:

Minutes

Location for training

Complete only if different from above

Address

Street + house number Location Postal code

Permission*

I agree to the privacy policy of Schok en Pomp Medical Training.*

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