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N. 34 page 2 GWRRA MEDIC FIRST AID ® TRAINING PROGRAMS
GOLD WING ROAD RIDERS ASSOCIATION, INC.
RIDER EDUCATION PROGRAM MEDIC FIRST AID ® TRAINING PROGRAMS

CarePlus Class Roster
Primary Instructor_________________________________________
GWRRRA
Number

Last Name of Student

First Name of Student

Course Date __________________
Chest
Compressions

Rescue
Breaths

Primary
Assessment

CPR

Basic AED

Personal
Safety Gloves

Control of
Bleeding

1
2
3
4
5
6
7
8
9
10
11
12
The students listed above have demonstrated competent performance, without assistance, of the skills I have checked off.
Signature of Primary Instructor ______________________________________________________________________
Complete both pages. Send ORIGINALto MEDIC FIRST AID ® Coordinator or Region Educator, who will retain the ORIGINAL and
mail a copy to LYDIA BOURG 935 ELDRIDGE ROAD #355 SUGAR LAND, TEXAS 77478 or email to [email protected]
Page 2 of 2
Revised January 2015