Please read this before completing the form: By completing this registration form, I am stating my intent to enroll in the University Emergency Medical Response EMT course #5, which is occurring in the SPRING of 2020. All information in this form is complete and accurate to the best of my knowledge, and I agree that completion of this form may be considered a binding agreement.
By checking below, I agree that I have reviewed all necessary forms, handouts, and class information and agree that I am eligible and able to complete the course.
I , the person named above, hereby agree to pay the FULL amount of $1799 (plus fees if applicable) to the University Emergency Medical Response, a Texas Non-Profit Entity for the purpose of paying for an EMT-Basic Course, unless otherwise told by Course Director that there is no longer room in the course. By signing below I understand and acknowledge that no refunds shall be given for any reason after I submit payment, and I acknowledge that I have read and understood the requirements to be in the class, and attest that I meet such requirements. I also understand and agree that if I fail the course, no refunds shall be given.
If you have any questions, please contact:
Scott Bell | Captain - EMS Education
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