Restart a Heart Day 2017 Participant Information

Restart a Heart Day events will be taking place all over the UK on 16th October 2017

Please use this form to tell us about the Restart a Heart activity you are planning. After the day, we will be in touch via the email provided to confirm exact numbers taught.

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* 1. Organiser contact details

Name *

Email Address

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* 2. School/youth group contact details

Name

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* 3. Please select which county your school/youth group is in

If 'Other', please state location

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* 4. Are you planning your activity in partnership with any of these organisations?

Regional Ambulance service

British Heart Foundation

St John Ambulance

British Red Cross

Other first aid training provider

Royal College of Emergency Medicine

Other

None of the above

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* 1. Organiser contact details

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* 2. School/youth group contact details

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* 3. Please select which county your school/youth group is in

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* 4. Are you planning your activity in partnership with any of these organisations?

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* 5. How many children do you expect to train on 16 October 2017?