Rapid Response Hybrid EMT Enrollment

Complete the information below to begin your enrollment with Rapid Response EMT.

Complete Your EMT Enrollment

STUDENT & PROGRAM INFORMATION

Program Information

Desired Start Date

Current EMS Certification Level

Prior Healthcare Experience

Primary Reason for Enrollment

PAYMENT AUTHORIZATION

By checking this box, I authorize Rapid Response Safety Training to charge the payment method I provide according to the tuition option I selected above.

If I select a payment plan, I authorize Rapid Response Safety Training and its payment processor to securely retain my payment method and process the scheduled payments associated with that plan until the tuition obligation is satisfied, subject to the applicable enrollment, refund, and withdrawal terms.

I understand that I remain financially responsible for any unpaid balance owed under my enrollment agreement and that unpaid balances may be referred for collection as permitted by applicable law.

I consent to receive non-marketing text messages from Rapid Response Safety Training related to my enrollment, account, course, payment, onboarding, scheduling, and other services I have requested. Message frequency may vary. Message & data rates may apply. Reply HELP for help or STOP to opt out.

EMERGENCY CONTACT

Please provide details for someone we can reach in case of a medical or logistical emergency.

Emergency Contact Name

Relationship

Phone Number

STEP 3 OF 3

ENROLLMENT AGREEMENT

Please review the terms of your enrollment and provide your digital signature below to secure your placement.

ENROLLMENT AGREEMENT & FINANCIAL RESPONSIBILITY

By checking this box and signing below, I acknowledge that I am enrolling in a course offered by Rapid Response Safety Training and agree to the total tuition associated with the program in which I enroll. I understand that I am financially responsible for any unpaid tuition balance, including in the event of withdrawal, dismissal, or non-completion, subject to Rapid Response Safety Training’s published refund and withdrawal policy.

I understand that my electronic acknowledgment and signature are intended to constitute my signature and agreement to these enrollment terms.

Refund / Withdrawal Policy Terms & Conditions

I acknowledge that I have reviewed and agree to the Enrollment Agreement & Financial Responsibility terms above.

Digital Signature (required)

Typing your name serves as your electronic signature.