Oct. 5, 2013 NC Sierra Club Outings Leader Training (OLT 101)and Basic First Aid Class Registration

Sierra Club OLT 101 & Basic First Aid Registration

We are excited that you will be attending the Sierra Club's Outdoor Leadership and First Aid training at the Chapel Hill Public Library on October 5th (9am-5pm)! Please arrive early to sign in and receive your training materials. Doors will be open at 8:30. Outdoor Leadership will be taught from 9am-1pm. This will satisfy the Outdoor Leadership Training (OLT)101 requirement to become a Sierra Club Outings Leader. Heartsaver First Aid will be taught by Durham Technical Community College Instructors from 1-5pm. This will satisfy the basic first aid requirement to become a Sierra Club Outings Leader. There is a $44 charge ($35 class fee plus $9 class book) for attending the first aid portion. Register for one or both portions of our training by completing the information below.

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* 1. Your contact information:

First name

Last name

Address

City

State

Zip

Email address

Phone

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* 2. How old are you?

under 18

18-22

23-29

30-39

40-49

50-59

60-69

70-79

Other (please specify)

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* 3. Please tell us what for what training you are signing up:

Outdoor Leadership Training (OLT101) ONLY

Heartsaver First Aid/basic first aid ONLY($35 class fee plus $9 workbook required)

BOTH OLT 101 and Heartsaver First Aid ($35 class fee plus $9 workbook required)

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* 4. If signing up for First Aid, will you pay by cash or check (in person at the training) or by credit card now?

I will not be taking the First Aid training

I will bring cash or check to the training

I will pay by credit card via eventbrite (to pay by credit card click here)

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* 5. Please tell us why you are signing up for this training:

to become a Sierra Club Outings Leader

to renew my Sierra Club Outings Leader Requirements

Other (please specify)

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* 6. Have you participated on a Sierra Club Outing before?

Yes

If yes, please tell us about recent outings/trips you have been on (where/when/activities/leaders' names)

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* 7. How did you hear about this Outdoor Leadership & Basic First Aid Training event?

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* 8. What kind of outings are you interested in leading? (check all that apply)

Local outings (day trips/hikes/activities)

Overnight trips

Overnight trips <5 days

Overnight trips >5 days

Outings with groups of children/teens (without their parents/guardians)

Other (please specify)

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* 9. Please check off all outdoor activities you are interested in leading:

Walking

Hiking

Canoeing

Kayaking

Bicycling

Camping

Other activities (please specify)

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* 10. Please list technical skill areas (i.e. kayaking, mountaineering, backcountry chef, bicycle repair, etc) in which you feel you are competent:

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* 11. For what populations would you like to lead? (check all that apply)

Adult

Seniors

Disabled

Families

Children

Teenagers/Pre-teens

No preference

Other (please specify)

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* 12. What is your level of First Aid certification?

None

Basic First Aid

Advanced First Aid

Wilderness First Aid

Wilderness First Responder

EMT

Wilderness EMT

Medical Professional (RN, MD, etc. Describe below.)

Medical professional degree

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* 13. If you have first aid training, what is the expiration date of your certification?

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* 14. Are you a Sierra Club member?

I'm a current member

I'm a past member

I'm not a member of the Sierra Club

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* 15. Are you currently, or have you been, an outdoor leader for another organization?

Yes

If yes, what kinds of groups have you lead? Where, and for how long?

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* 16. Please use this space for any comments/questions you may have. One of our Sierra Club training organizers will be in touch with you soon!

Please click "Done" (under the map below) to complete your registration. THANK YOU FOR SIGNING UP! We are looking forward to seeing you on October 5th! Library doors open at 8:30am.

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* 1. Your contact information:

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* 2. How old are you?

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* 3. Please tell us what for what training you are signing up:

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* 4. If signing up for First Aid, will you pay by cash or check (in person at the training) or by credit card now?

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* 5. Please tell us why you are signing up for this training:

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* 6. Have you participated on a Sierra Club Outing before?

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* 7. How did you hear about this Outdoor Leadership & Basic First Aid Training event?

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* 8. What kind of outings are you interested in leading? (check all that apply)

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* 9. Please check off all outdoor activities you are interested in leading:

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* 10. Please list technical skill areas (i.e. kayaking, mountaineering, backcountry chef, bicycle repair, etc) in which you feel you are competent:

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* 11. For what populations would you like to lead? (check all that apply)

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* 12. What is your level of First Aid certification?

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* 13. If you have first aid training, what is the expiration date of your certification?

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* 14. Are you a Sierra Club member?

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* 15. Are you currently, or have you been, an outdoor leader for another organization?

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* 16. Please use this space for any comments/questions you may have. One of our Sierra Club training organizers will be in touch with you soon!

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The Chapel Hill Public Library is located at 100 Library Drive, Chapel Hill, NC 27514.