Please fill out this form completely for Orange County pools, we may be in contact if we need more information

Minor Incident Report OC 2021

Person Filling Out Report
First Last
Date of Incident*
MM slash DD slash YYYY
Time

: Hours

Minutes

AM/PM
Pool Name
Person Involved in Injury or Incident*
First Last
Age*
If a minor, Name of Parent or Guardian
First Last
Nature and Treatment of Injury
CAPTCHA

You have selected a "Blended Learning" course.

2-410 hours online

1.525.5 hours classroom

IMPORTANT: You will not be able to participate in the classroom portion of the class without a completed certificate from the online portion. Failure to complete the online portion will mean you will need to pay for the course again.

Choose different class

I understand

While this may reduce your time in a classroom it also requires you to do the following prior to attending the in-person portion of your training:

Complete online blended learning course through the American Red Cross
Obtain an online completion certificate and bring it to the in-person skills portion of the class

Please fill out this form completely for Orange County pools, we may be in contact if we need more information

Minor Incident Report OC 2021

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