New Jersey Health & Safety Institute 

June 11-20, 2010 

20th Anniversary Year

Sponsored By 
American Red Cross, Burlington County Chapter 
and Burlington County College 


An authorized provider of NJ Department of Education CEUs 

www.healthandsafetyinstitute.org 


Non-Profit Org. 
US Postage 


PAID 

Mt. Holly, NJ 
Permit No. 462 


American Red Cross PLEASE FORWARD TO YOUR HEALTH & SAFETY TRAINING OR HUMAN RESOURCE DIRECTOR 
NJ Health & Safety Services 
1632 Route 38 
Lumberton, NJ 08048 

New this year: 

• 
Wilderness and Remote First 
Aid course. 
• 
Wilderness and Remote First 
Aid Instructor Course 
• 
Wilderness and Remote First 
Aid Instructor orientation 

TABLE OF CONTENTS 


TERMINOLOGY AND PROGRAM DEFINITIONS .. 2 
GENERAL INFORMATION........................................ 3 
PRE-REGISTRATION INFORMATION..................... 3 
CHECK-IN INFORMATION ...................................... 4 
REFUND POLICY ........................................................ 4 
DIRECTIONS AND MAP ........................................... 4 
CEU INFORMATION ................................................. 12 
AQUATICS SKILLS PRETESTS................................. 13 
FIRST AID AND CPR SKILLS PRETESTS................ 13 
GRAPHIC CHART OF COURSES .........................14-15 


AQUATICS INSTRUCTOR LEVEL COURSES 


AQUATIC SPECIALIST............................................... 5 


WSI/LIFEGUARDING PACKAGE (meets NJ DOE 
requirements) ................................................................ 5 
LIFEGUARDING r06 INSTRUCTOR PACKAGE ..... 5 
LIFEGUARDING r06 INSTRUCTOR ........................ 5 
WATER SAFETY r09 INSTRUCTOR ........................ 6 
BASIC WATER RESCUE INSTRUCTOR PACKAGE 

....................................................................................... 6 


FUNDAMENTALS OF CANOEING INSTRUCTOR 
PACKAGE ................................................................... 6 
SMALL CRAFT SAFETY INSTRUCTOR PACKAGE 

....................................................................................... 6 


AQUATIC INSTRUCTOR RE-ENTRY 
CROSSOVER/UPGRADE/ORIENTATION 


LIFEGUARDING r06 INSTRUCTOR RE-ENTRY/ 
CROSSOVER .............................................................. 6 

WATER SAFETY r09 INSTRUCTOR 
RE-ENTRY/CROSSOVER ......................................... 6 

AQUATIC BASIC LEVEL COURSE 


SHALLOW WATER ATTENDANT............................ 7 
LIFEGUARDING (POOL) r06 .................................... 7 
LIFEGUARDING/WATERFRONT r06 ...................... 7 
WATERFRONT LIFEGUARDING BRIDGE.............. 7 


LIFEGUARD MANAGEMENT .................................. 7 
BASIC WATER RESCUE ........................................... 7 
FUNDAMENTALS OF CANOEING .......................... 8 
SMALL CRAFT SAFETY ........................................... 8 
YMCA POOL OPERATORS COURSE ...................... 8 


AQUATIC BASIC LEVEL REVIEWS 


BASIC WATER RESCUE REVIEW .......................... 8 
LIFEGUARDING r06 REVIEW ................................. 8 
LIFEGUARDING/ WATERFRONT REVIEW (r06) ... 8 
SMALL CRAFT SAFETY REVIEW ........................... 8 

AQUATIC BASIC LEVEL CHALLENGE 
COURSES 


LIFEGUARDING r06 CHALLENGE .......................... 9 


CPR AND FIRST AID INSTRUCTOR LEVEL 
COURSES 


FIRST AID AND CPR INSTRUCTIONAL PACKAGE 
....................................................................................... 9 

LAY FIRST AID/CPR/AED INSTRUCTOR ............... 9 
CPR/AED FOR THE PROFESSIONAL RESCUER (r06) 
INSTRUCTOR .............................................................. 9 

EMERGENCY RESPONSE INSTRUCTOR .............. 9 
WILDERNESS AND REMOTE FIRST AID 
INSTRUCTOR .............................................................. 10 

CPR AND FIRST AID INSTRUCTOR LEVEL 
RE-ENTRY/CROSSOVER COURSES 


EMERGENCY RESPONSE (r06) INSTRUCTOR 
RE-ENTRY/CROSSOVER .......................................... 10 

WILDERNESS AND REMOTE FIRST AID 
INSTRUCTOR CROSSOVER .................................... 10 

CPR AND FIRST AID BASIC LEVEL 
COURSES 


FIRST AID/CPR/AED FOR SCHOOLS AND THE 
COMMUNITY............................................................... 10 
ADULT CPR/AED ...................................................... 10 
CPR/AED-ADULT & CHILD + INFANT CPR .......... 10 


CPR AND FIRST AID BASIC LEVEL 
COURSES 


TERMINOLOGY AND DEFINITION OF 
PROGRAMS 


STANDARD FIRST AID ............................................. 10 
CPR/AED FOR THE PROFESSIONAL RESCUER .. 10 
ADMINISTERING EMERGENCY OXYGEN .......... 11 
EMERGENCY RESPONSE ......................................... 11 
WILDERNESS AND REMOTE FIRST AID ............... 11 
SPORTS INJURY PREVENTION................................ 11 


CPR AND FIRST AID BASIC LEVEL REVIEW 
COURSES 


FIRST AID/CPR/AED FOR SCHOOLS AND THE 
COMMUNITY REVIEW ............................................ 11 

CPR/AED FOR THE PROFESSIONAL RESCUER 
REVIEW ...................................................................... 11 

CPR/AED COMBO REVIEW COURSE FOR 
LIFEGUARDS AND FIRST RESPONDERS............... 11 

EMERGENCY RESPONSE REVIEW ......................... 11 


BABYSITTER’S INSTRUCTOR COURSES 


Babysitter’s Training r08 Abbreviated Instructor Course 
....................................................................................... 11 

PROFESSIONAL DEVELOPMENT COURSES 


AMERICAN RED CROSS INSTRUCTOR TRAINER 
COURSE ...................................................................... 12 

Attention residential students: 
Do you dislike driving in the dark or very 
early in the morning? If you are traveling a 
long distance and your class begins early in 
the morning or ends very late at night, you 
can make arrangements to stay an 
additional night, either before or after your 
course, for the additional fee of $35.00 (to 
cover our costs). This fee includes 
overnight lodging and breakfast. To take 
advantage of this offer, please register in 
advance, using the course number below in 
addition to the course number of the course 
for which you are registering. 
#000 additional overnight lodging 

and breakfast $35.00 

BASIC LEVEL (SPECIALTY) COURSES: Designed for 
persons who desire to gain skills and knowledge in Health 
and Safety specialty courses (CPR, Lifeguarding and First 
Aid courses). 

BRIDGING: Specific to certain instructor courses to allow 
instructors to teach other specialties. 

CHALLENGE: Designed for a person who wishes to renew 
his certification by demonstrating skills and passing a 
written test without any further instruction or coaching. 

CEUs: Continuing Education Units. Where listed, they refer 
to EMT CEUs. People wanting education CEUs should 
advise their instructor of that desire. 

COMMUTER: Student who sleeps at home and drives back 
and forth to camp. 

COURSE: Contains the necessary skills and knowledge 
only for the specific area of study. 

CROSSOVER: Designed for those Instructors or Basic 
Level individuals who are certified by another organization 
i.e.: American Heart Association, Boy Scouts, YMCA, 
Ellis, etc. 

INSTRUCTOR LEVEL COURSES: Designed for a 
person 16 or 17 years and above who desires to teach Health 
and Safety Specialty Courses. Must have basic level skills. 
See course descriptions. 

ORIENTATION: Designed for those instructors who are 
certified in another specialty to enter a new specialty area or 
updated specialties. 

PACKAGE: Contains all the necessary Basic and/or 
Instructor level courses needed to gain skills and knowledge 
pertinent to the basic requirements for each program. 

r06, r09: Revision years of programs. 

RE-ENTRY: Designed for those Instructor level 
individuals whose certification has expired within two years 
to re-enter their specialty. 

RESIDENT: A student who stays at Mt. Misery overnight 

REVIEW: Designed for those whose certificates are about 
to expire to re-certify. 

ROLLOUT: Offered for instructors in a current program, 
which has been changed to new material. 

UPGRADE: Allows an instructor to gain new knowledge to 
be authorized in certain specialties. 

Please check schedule chart at end of booklet 
for course schedule details and ending times. 

CHART ABBREVIATIONS (PAGES 14,15) 

M ......................................Morning Classes 
A .......................................Afternoon Classes 
E .......................................Evening Classes 


2 



GENERAL INFORMATION 


The New Jersey Health and Safety Institute offers individuals and 
businesses the opportunity to access a wide assortment of American 
Red Cross Health and Safety courses that are offered at a single, 
centrally located site in a condensed time frame. The Institute 
appeals to the young person looking for skills to enhance summer 
employment prospects and to the seasoned professional looking to 
re-certify or gain needed CEUs to meet occupational requirements. 

We are an authorized provider of NJ Department of Education 
Continuing Education Units. Summer camps and recreational 
facilities can take advantage of the June dates to send counselors as 
students for lifeguard, water safety, and first aid certification. 
School Districts required to meet legislative requirements for 
aquatic faculty and coaches may use these courses to be compliant 
with the regulations. 

The NJHSI is in its 20th year of operation. The staff is 
diversified and has extensive training experience. All classes are 
held in English. The Institute is conducted under the authority of 
the American Red Cross Burlington County Chapter, which has a 
close working relationship with the Department of Health. 

FACILITY 


The institute is held in the heart of the Pine Barrens at the Pinelands 
Center at Mt. Misery in Browns Mills, NJ. Most aquatics and 
swimming sessions are held at the Burlington 
County College indoor pool in Pemberton. Some 

aquatic sessions and all boating sessions are held in the spring-fed 
lake on the camp property. 
Transportation to the college is provided. Classroom work is 
conducted in the several all-purpose buildings and rooms. Meals are 
served cafeteria style in the dining hall. On occasion, we will have 
family style meals. The cost of meals for both resident and 
commuter students is included in the course price. Special dietary 
needs can be met with advance notice on registration form. 

LODGING 


Overnight accommodations include cabins with a shower and 
bathroom. Cabins are typical summer camp cabins, either barracks 
style or with semi-private rooms. All cabins have bunks with 
mattresses. There is no air-conditioning. We reserve the right to 
make cabin assignments. There is also a centralized shower facility 
for commuters. However, there is no storage area for personal items 
for commuters. 
A list of area hotels is available on request. The nearest hotels are 
about 30 minutes away from Mt. Misery. If you intend to stay in 
a hotel, please register as a commuter and be aware that we will 
not cover the cost of this lodging. 

WHAT YOU NEED TO BRING WITH YOU 


We do not recommend the use of open toe shoes or flip-flops 
due to the possibility of foot and/or toe injury. 

Residents: 
Bed sheets, blankets or sleeping bag and pillow(s) 
Spring and summer clothing 
Hat and rain gear 
Towels and personal items 
Insect Repellent and medications 

Aquatics (both resident and commuter): 
Extra swimming suits and towels 
Warm and light clothing 
Sunscreen and sun block 
Mask and fins (if you have them) 
Optional wet suit 

DAILY SCHEDULE 


Time Activity 
7:00 AM Wake up call 
8:00 AM – 8:30 AM Breakfast (resident students and 
staff only) 
8:30 AM Commuter Students Check In 
9:00 AM – 12:00 PM Morning Class Session 
12:30 PM – 1:30 PM Lunch (if included with the 
course) 
1:30 PM – 5:00 PM Afternoon Class Session 
5:30 PM – 6:30 PM Dinner (if included with the 
course) 
6:30 PM – 10:30 PM Evening Course Session 
12:00 AM Lights out 

PRE-REGISTRATION INFORMATION 


Registration Deadline: Classes will be held only if there 
are students registered by June 4. After this date, you 
must call before registering. 

Pre-registration 

Full payment must accompany all registrations. Any mailed 
registration form that does not include a full payment with it 
will not be processed. Payment may be made by check, 
money order, purchase order or credit card (Visa, 
MasterCard, Discover Card or American Express). 

Website registration: 

http://www.healthandsafetyinstitute.org 
Online registration must be followed by payment, by phone, 
mail or in person before the date of the class. 

Phone: 

Phone pre-registrations may be made with a credit card. 
Phone #: (877) 658-9764 Monday – Friday 8:00-4:00PM 
TOLL FREE 
or 

(609) 267-9595 Monday – Friday 8:00-4:00PM 
Phone at camp 6/10-20/2010: 609-352-1890 

Fax: 

Fax pre-registration must be paid with a credit card (Visa, 
MasterCard, Discover Card or American Express), PO or 
check. 
FAX #: (609) 784-0128 (24 hours) 


Mail: must be received by June 4 

Please mail the Registration Form and payment to: 

American Red Cross 
Burlington County Chapter 
1632 Rt.38 
Lumberton, NJ 08048 


In Person: 

Pre-registration and payments may be made in person at the 
American Red Cross Burlington County Chapter, 1632 Rt 
38, Lumberton, NJ. Payments may be cash, check, money 
order or credit card (Visa, MasterCard, Discover Card or 
American Express). 
Office Hours: 8:00 AM -4:00 PM (Monday -Friday) 

3 



CHECK-IN REGISTRATION AT THECK-IN REGISTRATION AT THE 
INSTITUTE 


Please arrive at the Institute on time for your scheduled check in 
time. For those in the Aquatic courses, which have a swimming 
prerequisite, bring your bathing suit and towel to registration. 
You will want to bring a change of clothing if you are going to 
commute. 
If your course has a written test prerequisite, please review your 
textbook before arriving at the Institute. 
If your course has a skill prerequisite, please review the skills 
prior to the Institute. A list of the skills that will be tested can be 
found at the end of this brochure. 

No Meals Served at the 8:30 AM, 1:30 PM, 
or 6:00 PM Check In 

Please note that there are no meals served when you check in at 
these times. It is strongly suggested you bring a cold meal or eat 
before your arrival at the Institute. Soft drinks and snacks are 
available in the store. 

Proof of Certification 

If you are registered for any courses that require proof of 
certification, you must bring your current certificates with you to 
the Institute. Photocopies will not be accepted at check in. 

Proof of Age 

Any person registered for a course that has an age prerequisite 
should be able to provide proof of age if requested by Institute Staff 
at check in. A birth certificate, school ID, driver's license or any 
document that shows the birth date is acceptable. 
Resident students under the age of 18 may leave camp only with 
parental permission 

Special Dietary Needs 

You must notify the Institute staff on your registration form if you 
have special dietary needs. Any request after check in will not be 
accepted. 

Drug, Alcohol and Smoking Policy 
There is NO SMOKING on camp property, buildings, or trails. 
Smokers must use the road behind the dining hall ONLY. 
Drugs and alcohol are not allowed on camp property. 
Students in violation of the rules of camp will be asked to leave 
camp immediately. No refund will be given if you are asked to 
leave. 

REFUND POLICY 


No full refunds will be given. A refund of 
80% will be given with written notice of 
cancellation prior to June 7, 2010. For 
cancellations up to 48 hours before start of 
course, a refund of 60% will be given. No 
refund will be given to students who do 
not attend and have not given prior 
notice. Students who do not pass the 
applicable pre-test will be charged an 
administrative fee of $20, and all other 
payments will be refunded. 

MT MISERY MAP AND 
DIRECTIONS TO INSTITUTE 


Pinelands Center at Mt Misery 
801 Mt Misery Rd, Browns Mills, NJ 08015 

For more information call the Burlington County 
Chapter: 

(609) 267-9595 or Toll Free (877) 658-9764 
Monday – Friday 8:00-4:00PM EST 
Camp Phone (after June 9): 609-352-1890 

DIRECTIONS 


FROM THE WEST: 
Take the route of your choice to Route 70E (e.g.: Rts. 
206, 295 etc.) and head east to the junction of Rts. 70 and 


72. This is called the “Four Mile Circle.” From the 
circle, continue east on Rt. 70 for 3.9 miles to Mount 
Misery Road on your right (just past the 30-mile 
marker). Turn right onto Mount Misery Road and travel 
3/4 of a mile to the camp entrance. Please park in the 
field on your left. 

FROM THE EAST: 
Take the route of your choice to Route 70W (e.g.: 
Garden State Parkway, Rt. 9, etc.) and head west to the 
junction of Rts. 70, 530 and 539 (Exxon and WAWA 
intersection). From the junction, continue west on Rt. 70 
for approximately 8.5 miles to Mount Misery Road (just 
past the “Country Lakes” turn-off on your right). Turn 
left onto Mount Misery Road and travel 3/4 of a mile to 
the camp entrance. 
Parking: Please park in the field on your left, taking care 
not to obstruct fire lanes or areas marked by orange 
traffic cones. 

4 



AQUATIC INSTRUCTOR LEVEL COURSES 


Aquatic Specialist 
APPLICANTS MUST ALREADY BE LIFEGUARDS 
TO REGISTER FOR THIS COURSE! 

This is a comprehensive course which will prepare a person who is 
already a lifeguard to administer an aquatic facility and its 
programs. Included are Fundamentals of Instructor Training, 
Lifeguard Management, and instructorships in Water Safety r09 
and Lifeguarding. Completion of the pre-test will renew the 
student's basic lifeguarding AND CPR certifications. Students must 
tell the instructor if they are pool lifeguards or waterfront lifeguards 
at the beginning of the course so that they will take the appropriate 
pre-course skills test. Applicants who are already waterfront 
lifeguards will become waterfront lifeguard instructors. Bring mask 
and swim fins if possible. Bring extra bathing suits, towels, and 
warm clothing. Wear bathing suit to registration and bring a change 
of clothing if commuting. 
102 hours. CEUs 5.5 NJ, 8 PA 

No meals served at 6:00 PM Registration. Eat before you 
arrive or bring a cold brown bag meal. 
Prerequisites: Age 17 by June 20th. For WSI: excellent 
swimming skills. Must pass pretest; see page 13. For Lifeguard 
Instructor: must pass Lifeguard pretest and final test 

You must arrive no later than 6:00 PM for registration. 

#101 June 11-20 (6:00 PM Registration June 11) 
Cost: $875 Resident (Course Fees, Meals, Lodging) 
$645 Commuter (Course Fees, Meals) 

Water Safety Instructor/ Lifeguard Training Basic 
Certificate package (meets NJ DOE Requirements) 
This package meets the State of New Jersey Department of 
Education Statute for swim coaches. The student is trained as a 
Water Safety r09 Instructor and in Lifeguarding/Waterfront with 
CPR/AED, Oxygen Administration, Bloodborne Pathogens Training 
and First Aid. This course is suitable for pool and non-surf open 
water lifeguards. Designed for teachers, this package is open to any 
student. The student will learn how to deliver the Learn to Swim 
program. Also covered are teaching progressions for the Parent and 
Child Aquatics, Pre-School Aquatics, the 
six level progressive swimming program and Water Safety Today. 
Bring mask and swim fins if possible. Bring extra bathing suits, 
towels, and warm clothing. Wear bathing suit to registration and 
bring a change of clothing if commuting. 
102 hours CEUs 5.5 NJ 8 PA 


No meals served at 6:00 PM Registration. Eat before you 
arrive at the Institute or bring a cold brown bag meal. 
Prerequisites: Age 16 by June 20th. For WSI: excellent 
swimming skills. Must pass pretest; see page 13. For Lifeguarding: 
good swimming skills and pass waterfront lifeguarding pretest. 


You must arrive no later than 6:00 PM for registration. 

#102 June 11-20 (6:00PM Registration June 11) 
Cost $800.00 Resident (Course Fees, Meals, Lodging) 

$565.00 Commuter (Course Fees, Meals) 

Lifeguarding r06 Instructor Package 
This package includes both the basic Lifeguarding/Waterfront 
Lifeguarding certification for students who are not already 
lifeguards and the Lifeguard Instructor certification. The 
lifeguarding course will give students the knowledge and skills 
needed to recognize and respond quickly and effectively to 
emergencies and prevent drownings and injuries both in a pool and 
at a waterfront environment. The lifeguarding instructor course will 
train candidates to teach basic-level Lifeguarding, Waterfront 
Lifeguarding and Shallow Water Attendant (all including First Aid), 
Lifeguard Management, CPR/AED for the Professional Rescuer, 

Administering Emergency Oxygen, Bloodborne Pathogens Training: 
Preventing Disease Transmission and Basic Water Rescue courses. 
Instructor Candidates will also become familiar with GuardStart: 
Lifeguarding Tomorrow and Water Safety Presentations 
The package includes: Lifeguarding/Waterfront (r06), CPR/AED for 
the Professional Rescuer, First Aid, Waterfront Lifeguarding, 
Fundamentals of Instructor Training, Lifeguarding/Waterfront 
Instructor r06. Bring mask and swim fins if possible. Bring extra 
bathing suits, towels and warm clothing. Wear bathing suit to 
registration and bring a change of clothing if commuting. 67 hours. 
CEUs 5.5 NJ 8 PA. 

No meals served at 6:00 PM Registration. Eat before you 
arrive or bring a cold brown bag meal. 
Prerequisites: Age 17 by June 20th. Good swimming skills and 
ability to pass a swimming skills pretest. See page 13. 


You must arrive no later than 6:00 PM for registration. 

#103 June 11-20 (6:00 PM Registration June 11) 
Cost: $785.00 Resident (Course Fees, Meals, Lodging) 
$575.00 Commuter (Course Fees, Meals) 

Lifeguarding r06 Instructor 
Candidates should have the basic level training, its equivalent, 
or the skills and knowledge it encompasses. This course is 
designed to train instructor candidates to teach basic-level 
Lifeguarding, Waterfront Lifeguarding and Shallow Water 
Attendant (all including First Aid), Lifeguard Management, 
CPR/AED for the Professional Rescuer, Administering Emergency 
Oxygen, Bloodborne Pathogens Training: Preventing Disease 
Transmission and Basic Water Rescue courses. Instructor 
Candidates also will become familiar with GuardStart: Lifeguarding 
Tomorrow and Water Safety presentations. 
Completion of the pre-course skills and knowledge tests will renew 
the candidate’s basic level lifeguarding certification, first aid, 
CPR/AED for the Professional Rescuer, Oxygen Administration and 
Bloodborne Pathogens training certifications. 
Bring mask and swim fins if possible. Bring extra bathing suits, 
towels and warm clothing. Wear bathing suit to registration and 
bring a change of clothing if commuting. 32 hours. CEUs 5.5 NJ, 8 
PA 

No meals served at 6:00 PM Registration. Eat before you 
arrive at the Institute or bring a cold brown bag meal. 
Prerequisites: Age 17 by end of course. Successful completion of 
Lifeguarding pre-test and final skills and written tests, first aid and 
CPR for the Professional Rescuer skills and knowledge test. See 
page 13. 

You must arrive no later than 6:00 PM for registration. 
#104 June 11-13 and 18-20 must attend both weekends (6:00 

PM Registration June 11, 8:30 AM check-in June 18) 
#204 June 16-20 (6:00 PM Registration June 16) 
Cost: $520.00 Resident (Course Fees, Meals, Lodging) 

$425.00 Commuter (Course Fees, Meals) 

NEW! Most aquatic sessions will now be held in the 
Burlington County College Pemberton Campus 
heated indoor pool. Some waterfront lifeguarding 
skills will be taught in the lake at camp. Hot drinks 
and warm shelter are provided. 

“Resident” = staying at camp overnight 
“Commuter” = sleeping at home, driving back and 

forth to camp. 

5 



AQUATIC INSTRUCTOR LEVEL COURSES 


Small Craft Safety Instructor Package 

This package will prepare a candidate with the skills and knowledge 

Water Safety r09 Instructor 

This newly revised Water Safety Instructor course is open to those 
at least 16 years old. Through video and hands-on skill building, the 
course includes all the water safety and drowning prevention tools 
and information needed to plan and conduct courses in the 
American Red Cross Swimming and Water Safety Program, 
including Parent and Child Aquatics, Preschool Aquatics, Learn-to-

Swim, Longfellow’s WHALE Tales, Safety Training for Swim 

Coaches, six water safety-presentations and two water safety 
courses. 33 hours. Bring extra bathing suits, towels, and warm 
clothing. Bring bathing suit and towel to registration. 

No meals served at 6:00 PM Registration. Eat before you arrive 
at the Institute or bring a cold brown bag meal. 
Prerequisites: Age 16 by end of course. Excellent swimming skills 
and pass a swimming skills pretest. See page 13. 


You must arrive no later than 6:00 PM for registration. 

#106 June 11-13 and June 19-20. Must attend both weekends 
(6:00 PM Registration June 11). 
8:30 AM Check In June 19) 
#206 June 11-15 (6:00 PM Registration June 11) 
#306 June 16-20 (6:00 PM Registration June 16) 
Cost: $470.00 Resident (Course Fees, Meals, Lodging) 
$370.00 Commuter (Course Fees, Meals) 

Basic Water Rescue Instructor Package 

This is not a Lifeguarding Certification Course! 

This course is designed to provide individuals (public safety 
personnel, aquatic fitness instructors, aquatic therapists and youth 
group leaders) with the information and skills necessary to teach the 
Basic Water Rescue course to participants to prevent, recognize and 
respond to aquatic emergencies. The Basic Water Rescue course 
prepares students for aquatic emergencies by teaching them how to 
protect themselves while assisting others. Topics include self-rescue 
skills, reaching, throwing, and wading assists, and spinal injury 
management. This course includes: Basic Water Rescue, 
Fundamentals of Instructor Training and Basic Water Rescue 
Instructor. Bring extra bathing suits, towels and warm clothing. 
Bring bathing suit and towel to registration and bring a change of 
clothing if commuting. 
20 hours. CEUs 3.5 NJ, 3.0 PA. 

No meals served at 6:00 PM Registration. Eat before you arrive 
or bring a cold brown bag meal. 
Prerequisites: Age 17 by June 20. Pass skills pretest. 


See page 13. 

You must arrive no later than 6:00 PM for registration. 

#107 June 18-20 (6:00 PM Registration June 18) 
Cost: $300.00 Resident (Course Fees, Meals, Lodging) 

$250.00 Commuter (Course Fees, Meals) 

Fundamentals of Canoeing Instructor Package 

This package will allow the student to learn the basic level skills in 
canoeing as well as the Instructor level for flat water canoeing. The 
package includes Fundamentals of Instructor Training and 
Fundamentals of Canoeing Instructor and Fundamentals of Canoeing 
basic course. Bring extra bathing suits, towels and warm clothing. 
Wear bathing suit to registration and bring a change of clothing if 
commuting. 32 hours. 
Prerequisites: Age 17 by June 13. Ability to swim well, some basic 
knowledge of canoeing and successfully pass a swimming test based 
on basic swimming skills. See page 13. 

You must arrive no later than 8:30 AM for registration. 

#108 June 11-13 (8:30 AM Registration June 11) 
Cost: $340.00 Resident (Course Fees, Meals, Lodging) 

$285.00 Commuter (Course Fees, Meals) 

to teach students in the safe handling of small craft and in Basic 
Water Rescue. It is designed for those individuals who deal with 
youth groups at camps and Boy and Girl Scouts Units. The 
package includes Basic Water Rescue, Fundamentals of Instructor 
Training, Basic Water Rescue Instructor and the Small Craft Safety 
Instructor Orientation. Bring extra bathing suits, towels and warm 
clothing. Bring bathing suit and towel to registration and bring a 
change of clothing if commuting. 24 hours. CEUs 3.5 NJ, 3 PA 

No meals served at 6:00 PM Registration. Eat before you 
arrive or bring a cold brown bag meal. 
Prerequisites: Age 17 by June 20. Successfully pass a swimming 
skills pretest. See page 13. 


You must arrive no later than 6:00 PM for registration. 

#109 June 18-20 (6:00 PM Registration June 18) 
Cost: $320.00 Resident (Course Fees, Meals, Lodging) 
$275.00 Commuter (Course Fees, Meals) 

AQUATIC INSTRUCTOR RE-ENTRY/ 
CROSSOVER/ ORIENTATION 


Lifeguarding r06 Instructor Re-Entry/Crossover 

This course allows a former ARC Lifeguard Instructor (LGI) whose 
certification has expired within 2 years to re-certify or those who 
are certified by other organizations to cross over as an ARC LGI. 
Bring mask and swim fins if possible. Bring extra bathing suits, 
towels and warm clothing. Bring bathing suit and towel to 
registration and bring a change of clothing if commuting. 32 hours. 
CEUs 5.5 NJ 8 PA 
Prerequisites: Age 17 by June 20th. Proof of current authorization 
as a Lifeguard Training Instructor or proof of lapsed instructorship. 
Pass Lifeguard pre-test and final skills and written test. See page 13. 


You must arrive no later than 8:30 AM for registration. 

#110 June 18-20 (8:30 AM Registration June 18) 
Cost: $380.00 Resident (Course Fees, Meals, Lodging) 
$335.00 Commuter (Course Fees, Meals) 

Water Safety Instructor r09 Re-entry/Crossover 

This course allows a former ARC Water Safety Instructor (WSI) 
whose certification has expired within 2 years to re-certify or those 
who are certified by other organizations to cross over as an ARC 
WSI. Bring mask, snorkel and swim fins if possible. Bring extra 
bathing suits, towels and warm clothing. Bring bathing suit and 
towel to registration and bring a change of clothing if commuting. 
16 hours. 


No meals served at 6:00 PM Registration. Eat before you arrive 
or bring a cold brown bag meal. 
Prerequisites: Age 16 by June 13th. Proof of expired WSI 
certification within 2 years or proof of other agency certification. 
Must pass swimming skills pretest. See page 13. 


You must arrive no later than 6:00 PM for registration. 

#112 June 11-13 (6:00 PM Registration June 11) 
Cost: $330.00 Resident (Course Fees, Meals, Lodging) 

$280.00 Commuter (Course Fees, Meals) 

“Resident” = staying at camp overnight 
“Commuter” = sleeping at home or in a motel, 

driving back and forth to camp. 

6 



AQUATIC BASIC LEVEL COURSES 


Shallow Water Attendant 

The purpose of the American Red Cross Shallow Water Attendant 
course is to teach candidates the knowledge and skills needed to 
prevent and respond to aquatic emergencies in a shallow water 
environment (water that is up to 4 feet deep). The course content and 
activities prepare candidates to recognize and respond quickly and 
effectively to emergencies and prevent drownings and injuries in a 
shallow water facility or attraction. This course is NOT intended to 
train shallow water attendants for the shallow part of an area or 
attraction that also has deeper water (i.e. the shallow end of a 
traditional pool that ranges from shallow to deep water). 

Bring extra bathing suits, towels and warm clothing. Bring bathing 
suit and towel to registration and bring a change of clothing if 
commuting. 

No meals served at 6:00 PM Registration. Eat before you arrive 
or bring a cold brown bag meal. 
Prerequisites: minimum age of 15 by June 19th, Good swimming 
skills and must pass swimming pretest. See page 13. Proof of age 
required. 

You must arrive no later than 6:00 PM for registration. 

#114 June 11-13 and June 19. must attend both weekends 
(6:00 PM Registration June 11, 8:30 AM Check In June 
19) 
Cost: $290.00 Resident (Course Fees, Meals, Lodging) 
$240.00 Commuter (Course Fees, Meals) 

Lifeguarding (r06) (Pool only) 

The purpose of the American Red Cross Lifeguarding course is to 
teach candidates the knowledge and skills needed to prevent and 
respond to aquatic emergencies in a pool environment. This 
program includes CPR/AED for the Professional Rescuer, First 
Aid, Oxygen Administration, Bloodborne Pathogens Training: 
Preventing Disease Transmission, and Lifeguarding. Bring mask 
and swim fins if possible. Bring extra bathing suits, towels and 
warm clothing. Bring bathing suit and towel to registration and 
bring a change of clothing if commuting. 48 hours. CEUs 5.5 NJ 8 
PA 

No meals served at 6:00 PM Registration. Eat before you arrive 
or bring a cold brown bag meal. 
Prerequisites: minimum age of 15 by the last session of the 
course, good swimming skills and must pass swimming pretest. See 
page 13. Proof of age required. 

You must arrive no later than 6:00 PM for registration. 
#115 June 11-13 and June 19-20 must attend both weekends 

(6:00 PM Registration June 11. 8:30 AM. Check in June 
19) 
#215 June 11-15 (6:00 PM Registration June 11) 
#315 June 15-19 (6:00 PM Registration June 15) 
Cost: $350.00 Resident (Course Fees, Meals, Lodging) 

$250.00 Commuter (Course Fees, Meals) 

Lifeguarding/Waterfront (r06) 

The course of instruction is designed to teach the basic skills and 
knowledge needed to prevent and respond to aquatic emergencies in 
both a pool and at a waterfront environment. After successful 
completion, the lifeguard candidate will have the skills and 
knowledge to guard in pools and open water (non-surf) areas. This 
package includes: Waterfront Lifeguarding r06, CPR/AED for the 
Professional Rescuer, First Aid, Oxygen Administration, 
Bloodborne Pathogens Training:Preventing Disease Transmission. 
Bring mask and swim fins if possible. Bring extra bathing suits, 
towels and warm clothing. Bring bathing suit and towel to 
registration and bring a change of clothing if commuting. 60 hours. 
CEUs 5.5 NJ 8 PA 

No meals served at 6:00 PM Registration. Eat before you arrive 
or bring a cold brown bag meal. 
Prerequisites: minimum age of 15 by the last session of the 
course, good swimming skills and must pass swimming pretest. See 
page 13. Proof of age required. 

You must arrive no later than 6:00 PM for registration. 

#116 June 11-16 (6:00 PM Registration June 11.) 
#216 June 15-20 (6:00 PM Registration June 15) 
#316 June 11-13 and June 18-20 must attend both weekends 
(6:00 PM Registration June 11. 8:30 AM Check-in 
June 18.) 
Cost: $405.00 Resident (Course Fees, Meals, Lodging) 
$280.00 Commuter (Course Fees, Meals) 

Waterfront Lifeguarding Bridge 
This module is designed to teach those lifeguards already certified 
in Lifeguarding (its equivalent or the skills and knowledge it 
encompasses) the skills and knowledge needed to prevent and 
respond to emergencies at open water swimming areas (non-surf). 
Bring basic textbook or it may be purchased on site. Bring mask 
and swim fins if possible. Bring extra bathing suits, towels and 
warm clothing. Bring bathing suit and towel to registration and 
bring a change of clothing if commuting. 16 hours. 
Prerequisites: Proof of current certification in Lifeguarding r06 and 
current certification in CPR for the Professional Rescuer, the 
equivalents or skills and knowledge encompassed in these courses. 

You must arrive no later than 1:30 PM for registration. 

#117 June 19-20 (1:30 PM Registration June 19) 
Cost: $140.00 Resident (Course Fees. Meals, Lodging) 

$120.00 Commuter (Course Fees, Meals) 

Lifeguard Management 

In the Lifeguard Management course, the student will learn the 
knowledge and skills needed to effectively manage lifeguards and to 
create an environment that keeps patrons, lifeguards and the aquatic 
facility safe. The lifeguard management course covers the 
responsibilities of a lifeguard supervisor, the selection and training 
of lifeguards, team building, principles of injury prevention, risk 
management and emergency-response planning. 7 hours. 
Prerequisites: a lifeguarding background is useful, but is not 
required. 

You must arrive no later than 6:00 PM for registration. 

#118 June 14 and 16 (6:00 PM Registration June 14. Check in 

6:00 PM June 16) Must attend both evenings. 
Cost: $80.00 Commuter (Course Fees) 
Basic Water Rescue 

This is NOT a Lifeguarding certification course! 

This course will provide individuals such as public safety personnel, 
aquatic fitness instructors, aquatic therapists, youth group (Boy 
Scout and Girl Scout) unit leaders with information and skills 
necessary to prevent, recognize and respond to aquatic emergencies. 
This course will also prepare individuals for aquatic emergencies by 
teaching them how to protect themselves while assisting others. 
Topics also include recognition of the types of drowning victims, 
self-rescue skills, assistance to other swimmers, non-swimming 
rescues and spinal injury management. Bring bathing suit and towel 
to registration and bring a change of clothing if commuting. 
4 hours. CEUs 3.5 NJ, 3.0 PA. 

No Prerequisites. 

#119 June 12 (8:30 AM Registration June 12) 
#219 June 18 (6:00 PM Registration June 18) 
Cost $75.00 Commuter (Course Fees) 

7 



AQUATIC BASIC LEVEL COURSES 


Lifeguarding r06 Review (Pool Only) 

This course fulfills the requirements to maintain a current Lifeguard 

Fundamentals of Canoeing 

The course is designed to provide individuals an opportunity to learn 
about knots, basic paddling skills, rescues, craft handling and 
essential canoeing skills on flat water. Bring extra bathing suits, 
towels and warm clothing. Wear bathing suit to registration and 
bring a change of clothing if commuting. 24 hours. 
Prerequisites: Be able to pass a swimming skill test. See page 13. 
No age requirement. 


#120 June 11-12 (8:30 AM Registration June 11) 
Cost: $155.00 Resident (Course Fees, Meals, Lodging) 
$135.00 Commuter (Course, Fees, Meals) 

Small Craft Safety 

This course is designed for those individuals such as camp personnel 
and trip leaders who need information and skills necessary to 
prevent, recognize and respond to small craft emergencies. This 
course will also prepare individuals for small craft emergencies by 
teaching them how to protect themselves while assisting others. 
Certification is in two specialties: Canoeing and/or Rowing. Topics 
include recognition of distressed swimmers, trip planning, water 
environments, self-rescue, spinal injury management, safety 
guidelines for boating and canoeing. Bring extra bathing suits, 
towels and warm clothing. Wear bathing suit to registration and 
bring a change of clothing if commuting. 16 hours. CEUs 3.5 NJ, 3 
PA 


No meals served at 6:00 PM Registration. Eat before you arrive 
or bring a cold brown bag meal. 
Prerequisites: pass swimming, rowing, and paddling pretest. 
#121 June 18-19 (6:00 PM Registration June 18) 
Cost $130.00 Resident (Course Fees, Meals, Lodging) 


$110.00 Commuter (Course Fees, Meals) 

YMCA Pool Operations Course 

This course will prepare an individual with the knowledge and skills 
to properly maintain pool water conditions. Topics include Water 
Chemistry, balancing pool water, chemical conditioning, water 
testing, safe chemical handling and pool area inspections. YMCA 
employees must prove employment for discounted price. Bring a 
calculator for mathematical problems. 
8 – 12 hours. 
Prerequisites: Be at least 16 years of age. Good math skills. 
#122 June 19 (8:30 AM Registration June 19) 
Cost: $125.00 Commuter (Course Fees, Meals/Snack) 


AQUATIC BASIC LEVEL REVIEW 
COURSES 


Basic Water Rescue Review 

This course fulfills the requirements to maintain a current Basic 
Water Safety certification. Bring basic textbook or it may be 
purchased on site. Review textbook before arriving for course. 
Wear bathing suit to registration and bring a change of clothing if 
commuting. 2.5 hours 
Prerequisites: expiring current Basic Water Rescue certification 
#123 June 12 (8:30am registration June 12) 
Cost $45.00 Commuter (Course Fees) 

certification using the Lifeguarding r06 material. Bring your 
textbook or one may be purchased on site. Bring mask and swim 
fins if possible. Bring extra bathing suits, towels and warm 
clothing. Bring bathing suit and towel to registration and bring a 
change of clothing if commuting. 28 hours. 1 NJ CEU 

No meals served at 6:00 PM Registration. Eat before you arrive 
or bring a cold brown bag meal. 
Prerequisites: Be able to pass pre-test, page 13. Current 
certification in Lifeguarding or its equivalent or the skills and 
knowledge it encompasses. 

#124 June 18-20 (8:30 AM Registration June 18) 
Cost: $210.00 Resident (Course Fees, Meals, Lodging) 
$165.00 Commuter (Course Fees, Meals) 

Waterfront Lifeguarding Review r06 

This course fulfills the requirements to maintain a current 
Lifeguard/Waterfront certification using the Lifeguarding r06 
material. Bring your textbook or one may be purchased on site. 
Bring mask and swim fins if possible. Bring extra bathing suits, 
towels and warm clothing. Bring bathing suit and towel to 
registration and bring a change of clothing if commuting. 32 hours. 
1 NJ CEU 


No meals served at 6:00 PM Registration. Eat before you arrive 
or bring a cold brown bag meal. 
Prerequisites: Be able to pass pre-test, page 13. Current 
certification in Lifeguarding or its equivalent or the skills and 
knowledge it encompasses. 
#125 June 18-20 (8:30 AM Registration June 18) 
Cost: $220.00 Resident (Course Fees, Meals, Lodging) 


$170.00 Commuter (Course Fees, Meals) 

Small Craft Safety Review 

This course fulfills the requirement to maintain a current Small Craft 
Safety certification. Bring basic textbook or it may be purchased 
on site. Review textbook before arriving for course. Bring extra 
bathing suits, towels and warm clothing. Wear bathing suit to 
registration and bring a change of clothing if commuting. 4.5 hours 
Prerequisites: Expiring Small Craft Safety Certification. 
#126 June 19 (1:30 PM registration on June 19) 
Cost: $50.00 Commuter (Course Fees) 

NEW! Most aquatic sessions will now be held in the 
Burlington County College Pemberton Campus 
heated indoor pool. Some waterfront lifeguarding 
skills will be taught in the lake at camp. Hot drinks 
and warm shelter are provided. 

“Resident” = staying at camp overnight 
“Commuter” = sleeping at home, driving back and 

forth to camp. 

8 



AQUATIC BASIC LEVEL CHALLENGE 


Lifeguarding r06 Challenge 

This challenge course is not a review. It is designed for students who 
feel they are capable of demonstrating, without any instruction or 
practice, the skills and knowledge contained in the Lifeguarding 
course. You may only attempt this challenge once. Review the 
current textbook before attending. Books may be purchased at any 
Red Cross office or may be purchased on site. 

Please let the instructor know at the beginning of the course 
whether you are recertifying in Pool or Waterfront lifeguarding 
because the swimming test is different. Your certification will 
depend on which swimming test you complete. 
If you hold a current lifeguard certification but fail to successfully 
complete any part of the skills or knowledge portions, then you may, 
upon payment of the difference in price, transfer to the review 
course for re-certification If you fail the challenge and hold an 
expired lifeguard certification, there will be no refund of the class 
fee. Bring bathing suit and towel to registration and bring a change 
of clothing if commuting. 8 hours. 1 NJ CEU 

No meals served at 6:00 PM Registration. Eat before you arrive 
or bring a cold brown bag meal. 
Prerequisites: Hold a current lifeguard certification or have 
successfully completed a Red Cross Lifeguarding or another 
acceptable lifeguarding course within the last four years. 
Successfully pass swimming skills pretest (see page 13). Pass all 
scenarios posed to the student. Receive at least 80% on all written 

tests. 
#127 June 15 and 17 (6:00PM registration June 16. Must 
attend both evenings. Check in: 6:00PM June 15) 
Cost $110.00 Commuter (Course Fees) 

CPR AND FIRST AID INSTRUCTOR LEVEL 
COURSES 


First Aid and CPR Instructor Combo 

This combo is designed for those individuals who plan to teach a 
wide range of ARC first aid and CPR courses. Included are: 
Fundamentals of Instructor Training, CPR/AED for the 
Professional Rescuer Instructor with Oxygen Administration & 
Bloodborne Pathogens Instructor, and Lay Responder First 
Aid/CPR/AED Instructor. See specific instructor course 
descriptions below for more information on course contents. This 
course is designed for persons holding basic certifications in these 
courses or who can pass the equivalent skills and knowledge 
pretest. 

28 hours CEUs 5.5 NJ, 8 PA 
No meals served at 6:00 PM Registration. Eat before you 
arrive or bring a cold brown bag meal. 
Prerequisites: Minimum age of 17 by June 13. CPR and first aid 
skills. Must pass a written and skills pretest. See page 13 

#128 June 11-13 (6:00PM Registration June 11) 
Cost $410.00 Resident (Course Fees, Meals, Lodging) 
$360.00 Commuter (Course Fees, Meals) 

Lay Responder First Aid/CPR/AED Instructor 

This course is designed to train individuals to teach the new Lay 
Responder First Aid/CPR/AED courses, which are meant for use in 
schools, the community and workplace and meet OSHA 
requirements. These courses are modular in design, have flexible 
scheduling, include AED training, and 1-hour injury prevention 
modules, which can be used as part of the training or may stand 
alone for in-service training. This course is also designed for 
instructors who plan to teach First Aid:Responding to Emergencies 
or Sports Safety Training. Please let us know if this is the case so we 

may provide the appropriate instructor manuals. Topics include 
developing an understanding of the course materials, how to conduct 
training sessions, methods used to evaluate student progress and 
how to prepare and submit records and reports. Included are 
Fundamentals of Instructor Training and Lay Responder First 
Aid/CPR/AED Instructor certifications. 
24 hrs. CEUs 4 PA 

No meals served at 6:00 PM Registration. Eat before you arrive 
or bring a cold brown bag meal. 
Prerequisites: Minimum age of 16 by June 20. CPR and first Aid 
skills. Must pass a written and skills pretest. See page 13. 


#129 June 18-20 (6:00PM Registration June 18) 
Cost $360.00 Resident (Course Fees, Meals, Lodging) 
$315.00 Commuter (Course Fees, Meals) 

CPR/AED for the Professional Rescuer (r06) 
Instructor 

The course is designed to train individuals in how to teach CPR for 
the Professional Rescuer (consisting of Adult, Child, Infant, two 
person CPR skills and knowledge) and updated and expanded AED 
information and skills. Also included are oxygen administration and 
airway management information and skills; and preventing disease 
transmission (bloodborne pathogens) information, but not 
instructor certification in these areas. Topics include developing 
an understanding of the course materials, how to conduct training 
sessions, methods used to evaluate student progress and how to 
prepare and submit records and reports. This course includes 
Fundamentals of Instructor Training and CPR/AED for the 
Professional Rescuer Instructor Certifications. 
24hours. CEU s1 NJ,4 PA 


No meals served at 6:00 PM Registration. Eat before you 
arrive or bring a cold brown bag meal. 
Prerequisites: Minimum age of 17 by June 13. CPR skills. Must 
pass a written and skills pretest. See page 13. 
#132 June 11-13 (6:00 PM Registration June 11) 
Cost: $330.00 Resident (Course Fees, Meals, Lodging) 


$285.00 Commuter (Course Fees, Meals) 

Emergency Response Instructor r06 

The course will provide instructor candidates with the tools to teach 
the Emergency Response, CPR/AED for the Professional Rescuer, 
Oxygen Administration, and Bloodborne Pathogens training courses, 
conduct training sessions, evaluate student progress and maintain 
records and reports. Course materials have been updated to include 
the new CPR standards. The basic ER course is designed to provide 
those who have a duty to respond in emergency situations (first 
responders) with the knowledge and skills necessary to help sustain 
life, reduce pain and minimize the consequences of injury or sudden 
illness until advanced medical help arrives. It is highly 
recommended for police, fire, emergency squad, camp staff and 
workplace rapid response personnel. This package includes 
Fundamentals of Instructor Training and Emergency Response 
Instructor certifications. 
28 hours. CEUs 5.5 NJ, 8.0 PA. 


No meals served at 6:00 PM Registration. Eat before you arrive 
or bring a cold brown bag meal. 
Prerequisites: Minimum age of 17 by June 13. CPR and First Aid 
skills. Must pass a written and skills pretest. See page 13. 
#133 June 11-13 (6:00 PM Registration June 11) 
Cost: $425.00 Resident (Course Fees, Meals, Lodging) 


$375.00 Commuter (Course Fees, Meals) 

9 



Wilderness and Remote First Aid Instructor te First Aid Instructor 

This course is designed for those who wish to teach the new 
Wilderness and Remote First Aid course. Note that this course 
does not include certification to teach CPR. Fundamentals of 
Instructor Training is included in this course. Materials provided 
include a detailed instructor’s manual, an Emergency Reference 
Guide, and an 8-panel pocket guide. For more information about 
the basic level course, please look at Wilderness and Remote First 
Aid, #147, on page 11. 

Prerequisite: Must be 17 by June 20. In order to register for 
this course you must also register for #147 Wilderness and 
Remote First Aid and CPR or possess the equivalent 
certification from another agency such as ASHI, ECSI, NOLS, 
RMI, SOLO, WMA or WMI. 

#134 June 18-20 (6:00 PM Registration June 18) 
Cost $280.00 Resident (Course Fees, Meals, Lodging) 
$235.00 Commuter (Course Fees, Meals) 

CPR AND FIRST AID INSTRUCTOR LEVEL 
RE-ENTRY/CROSSOVER COURSES 


Emergency Response Instructor Re-entry/ 
Crossover 

This course allows a former ERI whose certification has expired 
within 2 years to re-certify or individuals who are certified by 
another agency to crossover to ARC ER Instructor. This course 
prepares individuals with a medical and instructor background to 
become a CPR/AED for professional rescuer and Emergency 
Response Instructor. Included are Fundamentals of Instructor 
Training and Emergency Response Instructor certifications. 
12 hours. CEUs 5.5 NJ, 8.0 PA. 
Prerequisites: Proof of expired ER Instructor certification within 2 
years or other agency current Instructor certification. Must pass a 
written and skills pretest. See page 13. 
#135 June 17 (8:30 AM Registration June 17) 
Cost: $345.00 Commuter (Course Fees, Meals) 

Wilderness and Remote First Aid Instructor 

Crossover 
If you are considering taking this course, please call the 
Burlington County Chapter office for more information. This 
course is available for current American Red Cross Health & 
Services instructors who possess valid basic-level Wilderness and 
Remote First Aid certification or equivalent wilderness first aid 
training from another agency. Former Wilderness First Aid Basics 
instructors may take this course. See course description for #147 for 
more information about this program. 

#136 June 16 (8:30 AM Registration June 16) 
Cost: $125.00 (Course Fees, Meals) 

Don’t forget to visit the camp store during your time 

at the New Jersey Health & Safety Institute for a 
great selection of drinks, snacks, and other supplies 
you might need during your stay. The camp store is 
located in Holly Hall, across from the dining room. 

CPR AND FIRST AID BASIC LEVEL 
COURSES 


First Aid/CPR/AED for Schools and Community 

This course is designed to train individuals and families to overcome 
any reluctance to act in emergency situations and to recognize and 
care for life-threatening emergencies such as respiratory or cardiac 
problems, sudden illness or injuries to infants, children or adults. 
Includes CPR/AED for Adults and Children and CPR for Infants, 
training in the use of Automated External Defibrillator and First Aid. 
8 hours. 
No Prerequisite. 


#140 June 12 (8:30 AM Registration June 12) 
#240 June 15 and June 17 (6:00 PM registration June 15. Must 
attend both evenings. Check in: 6:00 PM June 17) 
Cost: $75.00 Commuter (Course Fees) 

Adult CPR/AED 

This course is designed to train individuals to overcome any 
reluctance to act in emergency situations and to recognize and care 
for life-threatening respiratory or cardiac emergencies in adults. 
Includes Adult CPR and training in the use of Automated External 
Defibrillators. 4 hours. 
No prerequisites. 
#141 June 11 (6:00 PM Registration June 11) 
#241 June 15 (6:00 PM Registration June 15) 
Cost: $55.00 Commuter (Course Fees) 


Adult, Child and Infant CPR/AED 

This course is designed to train individuals in adult, infant and child 
CPR, and to overcome any reluctance to act in an emergency. You 
will learn to recognize and care for life threatening respiratory or 
cardiac emergencies in infants, children and adults on a basic level. 
Includes training in the use of Automated External Defibrillators. 6 
hours. 
No Prerequisites. 
#142 June 12 (8:30 AM Registration June 12) 
#242 June 15 and June 17 (6:00 PM registration June 15 Must 

attend both evenings. Check in: 6:00 PM June 17) 
Cost: $70.00 Commuter (Course Fees, Meals) 

Standard First Aid 

This course provides training in recognition and care for life-
threatening emergencies such as sudden illness, severe bleeding, 
injuries to muscles, bones and joints, and injuries to infants, 
children, or adults (No CPR component). 4 hours. 
No Prerequisites. 
#143 June 14 (6:00 PM Registration June 14) 
#243 June 19 (6:00 PM Registration June 19) 
Cost: $50.00 Commuter (Course Fees) 


CPR/AED for the Professional Rescuer 

This course is designed for people who are trained for and expected 
to act in an emergency to respond appropriately to respiratory and 
cardiac emergencies. Includes Adult and Child CPR/AED, Infant 
CPR and Two person CPR skills and knowledge. It is highly 
recommended for police, fire, emergency squad, camp staff and 
workplace rapid response personnel. This course meets the CPR 
requirement for New Jersey Lifeguards. Lifeguards will receive 1 
year cards, all others will receive 2 year cards. 

8 hours CEUs 6 NJ, 4 PA. 

No Prerequisites. 

#144 June 12 (1:30 PM Registration June 12) 
#244 June 19 (1:30 PM Registration June 19) 
Cost: $75.00 Commuter (Course Fees, Meals) 

10 



CPR AND FIRST AID BASIC LEVEL 
COURSES 


CPR AND FIRST AID BASIC LEVEL 
REVIEW COURSES 


Administering Emergency Oxygen 

This module familiarizes participants with the use of breathing 
devices for non-breathing persons and the delivery of supplemental 
oxygen for both breathing and non-breathing victims. 3 hours. CEUs 

2.0 NJ, 2.0 PA. 
No Prerequisites. 
#145 June 16 (6:00 PM Registration June 16) 
#245 June 20 (8:30 AM Registration June 20) 
Cost: $50.00 Commuter (Course Fees) 

Emergency Response (r06) 

The purpose of this course is to equip those individuals who have a 
duty to respond in emergency situations (FIRST RESPONDERS) with 
the knowledge and skills necessary to help sustain life and to reduce 
pain and minimize the consequences of injury or sudden illness until 
advanced medical help arrives. This course includes the current 
CPR/AED for the Professional Rescuer skills, and additional 
specialized skills and techniques used by first responders. It is 
highly recommended for police, fire, emergency squad, camp staff 
and workplace rapid response personnel. 
53 hours. CEUs 5.5 NJ, 28 PA. 

No meals served at 6:00 PM Registration. Eat before you arrive 
or bring a cold brown bag meal. 
No Prerequisites. 
#146 June 11-15 (6:00 PM Registration June 11) 
Cost: $430.00 Resident (Course Fees, Meals, Lodging) 


$330.00 Commuter (Course Fees, Meals) 

Wilderness and Remote First Aid and Adult CPR 

This course is designed for those who work, live or play in remote 
areas away from the usual EMS service. It follows Wilderness First 
Aid Curriculum and Doctrine Guidelines established for BSA. Ideal 
for employees and others in remote environments an hour or more 
from EMS response, and offers enhanced content and topics to meet 
OSHA Best Practices for Workplace First Aid Training Programs. 
Adult CPR is included in this course. This course meets the current 
wilderness first aid training requirements for a variety of 
organizations, including Boy Scouts of America, Girl Scouts of the 
USA, American Camp Association and American Canoe 
Association. Major portions of this course will be taught in an 
outdoor setting. Students who successfully pass this course will 
receive a 2 year certification. 20 hours. 

No meals served at 6:00 PM Registration. Eat before you arrive 
or bring a cold brown bag meal. 
Prerequisites. Must be 14 by June 13 

#147 June 11-13 (6:00 PM Registration June 11) 
Cost: $180.00 Resident (Course Fees, Meals. Lodging) 

$130.00 Commuter (Course Fees, Meals) 

Sports Injury Prevention and First Aid 

This course is designed for coaches and others who work in a sports 
setting, providing the knowledge and skills necessary to provide a 
safe environment to athletes while they are participating in sports, 
and in an emergency, to help sustain life and minimize the 
consequences of injury or sudden illness until medical help arrives. 
This course does not contain a CPR module. 
Prerequisites: none. 3.5 hours 
#148 June 16 (6:00 PM Registration June 16) 
Cost: $50.00 

First Aid/CPR/AED for Schools and Community 
Review 

This course is designed for those whose current certification in 
CPR/AED or First Aid is about to expire. Bring basic textbook or 
it may be purchased on site. Review textbook before arriving for 
course. 4 hours. 

Prerequisites: current certification. 

#150 June 13 (8:30 AM Registration June 13) 
Cost: $55.00 Commuter (Course Fees) 

CPR/AED for the Professional Rescuer Review 

This course is designed for those whose current certification in 
CPR/FPR is about to expire. Bring your textbook or it may be 
purchased on site. 4 hours. CEUs 1 NJ, 4 PA 
Prerequisites: current certification. 

#151 June 13 (1:30 PM Registration June 13) 
#251 June 14 (6:00 PM Registration June 14) 
#351 June 19 (8:30 AM Registration June 19) 
Cost: $55.00 Commuter (Course Fees) 

CPR/AED Combo Review Course for Lifeguards 
and First Responders 

This course combines a CPR/AED for Professional Rescuer Review 
course with Oxygen Administration and Bloodborne Pathogens; for 
Lifeguards, first responders, and others who need to recertify all 
three of these courses every year. Bring your basic textbook or it 
may be purchased on site. Lifeguards will receive 1 year cards, 
all others will receive 2 year cards. 

6 hours. CEUs 5.5 NJ, 8 PA 

Prerequisites: current certification. 

#152 June 13 (1:30 PM Registration June 13) 
#252 June 19 (8:30 AM Registration June 19) 
Cost: $75.00 Commuter (Course Fees) 

Emergency Response Review 

The course is for those who have a certification in Emergency 
Response that is about to expire. Bring basic textbook or it may be 
purchased on site. Review textbook before arriving for course. 24 
hours. CEUs 5.5 NJ, 8.0 PA. 

Prerequisites: current certification. 

#153 June 18-20 (6:00 PM Registration June 18) 
Cost $220.00 Resident (Course Fees, Meals, Lodging) 

$170.00 Commuter (Course Fees, Meals) 

BABYSITTER’S INSTRUCTOR COURSES 


Babysitter’s Training r08 Abbreviated Instructor 
Course 

This course is designed for current American Red Cross instructors 
who want to become babysitters instructors, former American Red 
Cross Babysitter's Training instructors whose authorizations have 
been expired for no more than 2 years, licensed Registered Nurses, 
Nursing students currently enrolled in a nursing program leading to 
licensure as a Registered Nurse and who have completed one 
clinical rotation, school teachers, youth leaders who have 
experience teaching (Girl Scout and Boy Scout leaders), child care 
providers who have completed early childhood education or similar 
training. Topics include leadership, the business of babysitting, 
safety on the job, understanding kids from 0 to 10.caring for kids, 
and responding to emergencies. The Instructor's manual includes 
lesson plans, master response sheets, and a CD-ROM with 
additional materials, worksheets, and instructor resources. 4 hours 

11 



Prerequisites: Must be at least 16 years of age by end of course, 
hold a Fundamentals of Instructor Training certificate issued 
within the last year, or a current American Red Cross Health 
and Safety Services instructor authorization or complete the 1hour 
online orientation to the Red Cross. 
hold a Fundamentals of Instructor Training certificate issued 
within the last year, or a current American Red Cross Health 
and Safety Services instructor authorization or complete the 1hour 
online orientation to the Red Cross. 

#160 June 16(6:00 PM Registration June 16) 
Cost: $95.00(Course Fees, materials) 

PROFESSIONAL DEVELOPMENT COURSES 


American Red Cross Instructor Trainer Course 

This course prepares selected ARC Instructors to become ARC 
Instructor Trainers. Please contact Burlington County Chapter 
before registering for this course for more information and to receive 
necessary advance paperwork.. 
Prerequisites: Completion of Part I of the Application/Worksheet 
for Instructor Trainers and approval from local chapter or State 
Supervisory Committee. 
20 hours. 
#161 June 12-13 (8:30 AM Registration June 12) 
Cost: $110.00 Resident (Course Fees, Materials, Meals, 
Lodging $90.00 Commuter (Course Fees, Materials) 


Continuing Education Units 

A variety of CEUs are available to participants in these courses: 

1. New Jersey Department of Education CEUs-teachers may 
request these by indicating at the beginning of a course that they 
would like a certificate which indicates the number of hours spent 
in class. 
2. New Jersey EMT CEUs-the number of CEUs available in each 
class is indicated in the course description. CEUs for CPR/AED for 
the professional rescuer courses are obtained by submitting a copy 
of the certification card to the NJOEMS. For other courses, you 
must fill out paperwork during the class. 
3. Pennsylvania EMT CEUs-for people holding Pennsylvania EMS 
license. Paperwork must be filled out during class 
Other Training Opportunities 

Throughout the year we offer basic courses in First Aid and CPR to 
the Community at several convenient locations. Please contact the 
Chapter office for more information about these courses. 
If you are in need of training courses for your workplace, we also 
offer full-service courses on a variety of topics designed to suit your 
needs. In addition to CPR and First Aid, we offer a selection of 1hour 
modules on topics such as workplace violence, stress relief, 
heart health, and workplace safety. Presentations on disaster 
preparedness can also be scheduled for workplace and community 
groups. 
Instructor courses are also offered during our Spring and Fall 
Instructor Academies. Aquatic instructor courses are only offered 
during the Health and Safety Institute 

. 

Volunteer Opportunities 

Do you have free time on your hands? Are you looking for a 
satisfying way to spend that time? Come be a Red Cross volunteer. 
Volunteers are needed to work at blood drives, help in times of 
disaster, and to perform those many jobs in the office that require 
another helping hand, from answering phones and cleaning 
equipment to maintaining important records or doing other office 
work. If you are interested, just call to ask for an application. 

(609)267-9595 ext 126 

INSTITUTE STORE 


The Institute store can be found at Holly Hall, and will be open at 
times convenient for students. Payments can be made by cash, 
check, or credit card. Don’t forget to redeem your instructor shirt 

certificate at the store at the conclusion of your instructor class. 
ALSO FOUND AT THE STORE: 

4. IACET CEUs-The American Red Cross has been approved as an 
Authorized Provider by the International Association for 
Continuing Education and Training (IACET). CEUs are offered as 
an add-on to training courses completed through the American Red 
Cross. Visit www.iacet.org to review a list of companies, regulatory 
boards and organizations that have reported to accept the IACET 
CEU. Individuals are strongly encouraged to check with their 
specific regulatory boards, employers or other agencies to confirm 
that courses taken from IACET Authorized Providers and courses 
taken for IACET CEUs will be accepted by that entity. 
How to obtain CEUs after successful completion of a Red Cross 
Course 
1. 
Visit www.RedCross.org/store 
2. 
Provide the course name, date and location (including 
address, city and ZIP code), American Red Cross Chapter 
name and the Instructor’s name. 

3. 
Select the CEU for the course and pay the fee. 
4. 
Upon verification of course completion, the CEU 
certificate will be emailed to you within four weeks; hard 
copy on request. 
Pet First Aid Kits ¨ 
Lifeguard First Aid Kits 
First Responder Kit ¨ 
First Aid Station Kit 
Instructor Shirts ¨ 
Lifeguard Shirts 
Waist Pack First Aid Kits 
Breathing Barriers 
Collectible Banks ¨ 
Key Chains 
Hats ¨ 
Goggles ¨ 
Whistles 
Lanyards ¨ 
ShamWows ¨ 
Sunblock 
Soft Drinks ¨ 
Ice Cream ¨ 
Candy 
Power Bars ¨ 
Snack Cakes 


These are only a few of the items available at the 
Institute Store and at the 
Burlington County Chapter of 
American Red Cross. 


12 



13 
AQUATICS SKILLS PRETESTS 
SHALLOW WATER ATTENDANT 
1. Swim 50 yards continuously, using these strokes in the following 
order:·
25 yards front crawl with rhythmic breathing and 
stabilizing, propellant kick. Breathing can be performed 
either by breathing to the side or to the front. 
· 25 yards Breaststroke using a pull, breathe, kick and glide 
sequence. 
2. Starting in the water, swim 20 yards using the front crawl or 
breaststroke, submerge to a depth of 4 feet, retrieve a 10-pound 
object, return to the surface, walk 20 yards back to the starting 
point with the object and exit the water without using a ladder or 
steps, within 50 seconds. 
LIFEGUARDING (POOL) SKILLS 
1. Swim 300 yards continuously, using these strokes in the 
following order: 
· 100 yards front crawl with rhythmic breathing and 
stabilizing, propellant kick. Breathing can be performed 
either by breathing to the side or to the front. 
· 100 yards Breaststroke using a pull, breathe, kick and glide 
sequence. 
· 100 yards of either the front crawl or breaststroke, The 100 
yards may be a combination of those strokes. 
2. Starting in the water, swim 20 yards front crawl or breaststroke, 
surface dive to 7-10 feet, retrieve a submerged 10 pound object, 
return to surface and swim back to starting point with the object 
and exit the water without using a ladder or steps, within 1 
minute, 40 seconds. 
WATERFRONT LIFEGUARDING SKILLS 
1. Swim 550 yards continuously, using these strokes in the 
following order: 
· 200 yards front crawl with rhythmic breathing and 
stabilizing, propellant kick. Breathing can be performed 
either by breathing to the side or to the front. 
· 200 yards Breaststroke using a pull, breathe, kick and 
glide sequence. 
· 150 yards of either the front crawl or breaststroke, The 
150 yards may be a combination of those strokes. 
2. Starting in the water, swim 20 yards front crawl or breaststroke, 
surface dive to 7-10 feet, retrieve a submerged 10 pound object, 
return to surface and swim back to starting point with the object 
and exit the water without using a ladder or steps, within 1 
minute, 40 seconds. 
3. Swim 5 yards, submerge and retrieve three dive rings placed 5 
yards apart in 4-7 feet of water, resurface and swim 5 yards to 
the side of the pool. 
WATER SAFETY INSTRUCTOR AND RE-ENTRY/ 
CROSSOVER 
Pass a swimming skills test: 
· Front Crawl 25 yards 
· Back Crawl 25 yards 
· Sidestroke 25 yards 
· Breaststroke 25 yards 
· Elementary Backstroke 25 yards 
· Butterfly 15 yards 
· Maintain position while floating on back in deep water for 
one minute 
· Tread water for one minute 
LIFEGUARD INSTRUCTOR AND REVIEWS 
1. Pass Lifeguarding and CPR/FPR written tests with 80%. 
2. Perform the following skills: 
· Perform CPR and First Aid Skills scenario 
· Perform Waterfront Lifeguarding Pretest 
· Perform Active Drowning scenario 
· Perform Spinal Injury scenario 
· Perform active victim rescue board rescue 
· Perform passive victim rescue board rescue 
FUNDAMENTALS OF CANOEING 
Enter deep water, float, swim or tread water for three (3) minutes. 
CANOEING INSTRUCTOR 
1. Pass a written test with 80%. 
2. Perform the following skills, both solo and tandem: 
· Duffek stroke 
· Sideslips 
· Straight Line (fast and slow) 
· Dock landings 
· General combined skills (gate course) 
SMALL CRAFT SAFETY/BASIC WATER RESCUE 
Perform the following skills: 
· Float or tread water for 1 minute without lifejacket 
· Swim any stroke for 25 yards without a lifejacket 
· Swim any stroke for 25 yards with a lifejacket 
· Demonstrate basic boat handling skills for the rowboats 
and canoes on a set course (SCS only) 
FIRST AID AND CPR SKILLS PRETESTS 
FIRST AID AND CPR INSTRUCTOR, AND RE-ENTRY/ 
CROSSOVER 
1. Pass written test with 80%. 
2. Perform the following skills: 
· Check for unconsciousness 
· Chest thrusts for unconscious choking adult or child 
· Back blows and abdominal thrusts for conscious choking 
adult or child 
· Back blows and chest thrusts for unconscious choking 
infant 
· Back blows and chest thrusts for conscious choking infant 
· Adult, Child and Infant CPR 
· Control bleeding 
· Anatomic splint, soft splint, rigid splint, sling 
· AED 
CPR FOR THE PROFESSIONAL RESCUER INSTRUCTOR, 
CHALLENGE AND RE-ENTRY/ CROSSOVER 
1. Pass written test with 80%. 
2. Perform the following skills: 
· Obstructed Airway for conscious adult and infant 
· Obstructed Airway for unconscious adult and infant 
· Adult, child and infant CPR/AED 
· Two rescuer CPR: 
o Beginning together 
o Changing positions 
· Use of resuscitation mask 
· Use of bag-valve mask (Two Rescuers) 
EMERGENCY RESPONSE INSTRUCTOR 
1. Pass written test with 80%. 
2. Perform the following skills: 
· Glove removal 
· Rescue moves 
· Initial Assessment 
· Physical Exam and SAMPLE History 
· Measuring blood pressure 
· Unconscious obstructed airway adult and infant 
· Conscious obstructed airway adult and infant 
· CPR for Professional Rescuer skills in section above

M-Morning Classes A-Afternoon Classes E-Evening Classe-Morning Classes A-Afternoon Classes E-Evening Classes 


Courses Fri. June 11 Sat. June 12 Sun. June 13 Mon. June 14 Tue. June15 Wed. June 16 Thu. June 17 Fri June 18 Sat. June 19 Sun. June 20 
M A E M A E M A E M A E M A E M A E M A E M A E M A E M A E 
101 Aquatic Specialist 
102 WSI/LG Pkg 
103 Lifeguard Instructor Pkg. 
104 Lifeguard Instructor 
204 Lifeguard Instructor 
106 Water Safety Instructor 
206 Water Safety Instructor 
306 Water Safety Instructor 
107 BWR Instructor Pkg 
108 Fund. Of Canoeing Inst. 
109 Small Craft Safety Inst. Pkg 
110 LGI Re-entry/Crossover 
112 WSI RE-entry/crossover 
114 Shallow Water Attendant 
115 Lifeguarding (Pool) 
215 Lifeguarding (Pool) 
315 Lifeguarding (Pool) 
116 Lifeguarding, Pool / Waterfrnt 
216 Lifeguarding, Pool / Waterfrnt 
316 Lifeguarding, Pool / Waterfrnt 
117 Waterfront Lifeguard bridge 
118 Lifeguard Management 
119 Basic Water Rescue 
219 Basic Water Rescue 
120 Fundamentals of Canoeing 
121 Small Craft Safety 
122 YMCA Pool Operator 
123 Basic Water Rescue Review 
124 Lifeguarding Review (pool) 
125 WFLG Review 
126 Small Craft Safety Review 
127 Lifeguard Challenge 

14 



M-Morning Classes A-Afternoon Classes E-Evening Classe-Morning Classes A-Afternoon Classes E-Evening Classes 


Courses Fri. June 11 Sat. June 12 Sun. June 13 Mon. June 14 Tue. June 15 Wed. June 16 Thu. June 17 Fri June 18 Sat. June 19 Sun. June 20 
M A E M A E M A E M A E M A E M A E M A E M A E M A E M A E 
128 FA & CPR Instructor Combo 
129 Lay FA/CPR/AED Instructor 
132 CPR/AED FPR Instructor 
133 ER Instructor 
134 WRFA Instructor 
135 ER Instructor RE/CO 
136 WRFA Inst CO 
140 FA/CPR/AED Community 
240 FA/CPR/AED Community 
141 Adult CPR/AED 
241 Adult CPR/AED 
142 Adult, Child, Inf. CPR/AED 
242 Adult, Child, Inf. CPR/AED 
143 Standard First Aid 
243 Standard First Aid 
144 CPR/AED for Professional 
244 CPR/AED for Professional 
145 Admin. Emergency Oxygen 
245 Admin. Emergency Oxygen 
146 Emergency Response 
147 WRFA & ACPR 
148 Sports Injury Prevention 
150 FA/CPR/AED Review 
151 CPR/AED /FPR Rev. 
251 CPR/AED /FPR Rev. 
351 CPR/AED /FPR Rev. 
152 CPR/AED+O2+BBP Rev. 
252 CPR/AED+O2+BBP Rev. 
153 Emergency Response Rev. 
160 Babysitter’s Instructor 
161 ARC Instructor Trainer 

15 



2009 NJ HEALTH AND SAFETY INSTITUTE 
Burlington County Chapter, American Red Cross Burlington County Chapter, American Red Cross 

REGISTRATION FORM (Please Print) 

Name: 
(Last) 
Address 
(First) (Middle) 
Sex: M F Birthdate / 
Month 
/ 
Day Year 
City State Zip: 
Telephone Day: ( ) Evening:( ) FAX:( ) 
E-mail Address: 
Employer Information: 
(Name) (Address) 

(City) (State) (Zip Code) 
Resident (staying at camp overnight) 

Commuter (sleeping at home) 
Special Diets (Please check if applicable) Vegetarian 

Kosher 

Other 
Food Allergies________________________________________________________________________________________ 

Emergency Contact: Name: Relationship: 
Telephone Day:( ) Evening:( ) 
Course Number: 
# 
Title: Fees: 
$ 

#$ 

#$ 

#$ 

Total fees enclosed: $ 

I am already an American Red Cross Instructor 

If paying by check, make check payable to: American Red Cross 

Credit Card Payment (fill in all information, please) 
MC Visa AMEX Discover #: 
Expiration Date: 
Month 
Send To: 
/ Signature: (credit card owner) 
Year 
American Red Cross 
Burlington County Chapter 
1632 RT 38 
Lumberton, NJ 08048 
Billing Zip Code:___________________________ 
Return By: June 5, 2009 

For more information call: American Red Cross Burlington County Chapter (609) 267-9595 or Toll Free (877) 658-9764 
E-mail: njhss@redcrossbcnj.org 

Office Use Only 

Date Received: Date Paid:___________________________ 
Course #: Amt Due: Amt Paid: Bal.Due: Customer #: 
Course #: Amt Due: Amt Paid: Bal.Due: Customer #: 
Course #: Amt Due: Amt Paid: Bal.Due: Customer #: 
Cash: M.O.: Check: M.O./Check no. #:______________ Credit Card Card Run ______Inv._______________ 


2009 NJ HEALTH AND SAFETY INSTITUTE 
Burlington County Chapter, American Red Cross Burlington County Chapter, American Red Cross 

REGISTRATION FORM (Please Print) 

Name: 
(Last) 
Address 
(First) (Middle) 
Sex: M F Birthdate / 
Month 
/ 
Day Year 
City State Zip: 
Telephone Day: ( ) Evening:( ) FAX:( ) 
E-mail Address: 
Employer Information: 
(Name) (Address) 

(City) (State) (Zip Code) 
Resident (staying at camp overnight) 

Commuter (sleeping at home) 
Special Diets (Please check if applicable) Vegetarian 

Kosher 

Other 
Food Allergies________________________________________________________________________________________ 

Emergency Contact: Name: Relationship: 
Telephone Day:( ) Evening:( ) 
Course Number: 
# 
Title: Fees: 
$ 

#$ 

#$ 

#$ 

Total fees enclosed: $ 

I am already an American Red Cross Instructor 

If paying by check, make check payable to: American Red Cross 

Credit Card Payment (fill in all information, please) 
MC Visa AMEX Discover #: 
Expiration Date: 
Month 
Send To: 
/ Signature: (credit card owner) 
Year 
American Red Cross 
Burlington County Chapter 
1632 RT 38 
Lumberton, NJ 08048 
Billing Zip Code:___________________________ 
Return By: June 5, 2009 

For more information call: American Red Cross Burlington County Chapter (609) 267-9595 or Toll Free (877) 658-9764 
E-mail: njhss@redcrossbcnj.org 

Office Use Only 

Date Received: Date Paid:___________________________ 
Course #: Amt Due: Amt Paid: Bal.Due: Customer #: 
Course #: Amt Due: Amt Paid: Bal.Due: Customer #: 
Course #: Amt Due: Amt Paid: Bal.Due: Customer #: 
Cash: M.O.: Check: M.O./Check no. #:______________ Credit Card Card Run ______Inv._______________