Sheboygan Falls YMCA
305 Buffalo St, Sheboygan Falls, WI 53085
P 920.467.2464 l F 920.467.4641
www.sheboygancountyymca.org
Babysitter training + cpr/first aid certification
june 12 - 14 q july 10 - 12 q august 14 - 16, 2017
Age 10 & Older
These trainings are at the Sheboygan Falls YMCA. Participants will learn how to provide care to younger
children in a variety of age groups and how to prevent and respond to emergencies. Information presented
in each lesson is very important. Participant must show maturity and readiness to babysit. Participants who
successfully complete the course will receive a Babysitter/Shaken Baby Prevention certificate.
The American Red Cross CPR certification takes just a few short hours, but can help you add years to
someone’s life. Successful completion gives you a two-year certification in infant and child CPR. The American
Red Cross first aid training classes give you the information and the skills you need to help children during
many emergency situations.
A pizza lunch and beverage will be provided on Wednesday. There is a maximum of 10 participants in
each 3-day session.
The Fee Includes:
• Babysitter Training Participant’s Set
• CPR and First Aid Certification
• Pocket First Aid Pack
• American Red Cross LED Flat Flashlight w/Magnet
• American Red Cross Drawstring Backpack
Monday - Wednesday............ 9:00am - 12:00pm
Sheboygan falls YMCA 2017 summer babysitter & cpr/first aid trainings
Return to the Sheboygan Falls YMCA, 305 Buffalo St, Sheboygan Falls, WI 53085 l 920-467-2464
Child’s Name_______________________________________ Grade________ Birth Date________________  M  F
Address___________________________________________ City____________________________ State________
Zip Code________________ Phone 1_____________________________ Phone 2_____________________________ Email_____________________________________________ School______________________________________
Emergency Contact_________________________________________Phone #____________________________ If child has any food allergies, please list:_________________________________________________________
_____________________________________________________________________________________________
hold harmless agreement
I hereby agree to waive any claim or liability I may have on the YMCA arising out of use of the facility, and further agree
that I will indemnify and save harmless the YMCA from any and all claims brought against the YMCA, its members and
volunteers, on account of death, injury, or damage to persons or property received by any persons by reason of the acts
or omissions of the users in their use. I also agree to waive any claims against the YMCA, its members and volunteers for
injuries or damages that may result from the conduct of other persons, including participants in the program. I understand the above responsibilities and I give permission for my child to participate and be photographed in YMCA activities.
Participant or Parent Signature_____________________________________________ Date__________________
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R Fee per 3-Day Session
Session 17SU-2YBABYSIT..
6/12 - 6/14  $60.00 Fee includes Babysitter Training + CPR/First Aid Certification
7/10 - 7/12
8/14 - 8/16
Receipt #________________________ Amount Paid_______________ Rec’d By_______________ Date____________