PALS, PEARS, and ACLS "*" indicates required fields Which training would you like to attend*NOTE: It is the sole responsibility of every participant to add only dates they know they are available to attend. We suggest you review our cancellation policy. Without a 21 business day cancellation there is no refund. Prior to 21 business days if you request a date change there is a $25.00 fee payable by the participant at time of request. A date change request less than 21 business days, the participant is responsible for the full course fee. Pediatric Advanced Life Support (PALS) Pediatric Emergency Assessment, Recognition and Stabilization (PEARS) Advanced Cardiovascular Life Support (ACLS) Provider Course or Update Course**All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* Provider Course Update Course Training Dates - PALS Provider Course*Please choose 3 dates and use the special instruction box to list choices in order. When you only choose 1 date this holds up the process of getting you seated and you may have to fill out a new form. Once confirmed into a course, there is an administration fee for date changes and cancellations. All 3rd quarter dates have filled. We do not accept forms without available dates. Watch for the release of 4th quarter dates in July 2023. Training Dates - PALS Update Course*Please choose 3 dates and use the special instruction box to list choices in order. When you only choose 1 date this holds up the process of getting you seated and you may have to fill out a new form. Once confirmed into a course, there is an administration fee for date changes and cancellations. TEXTBOOKS: For Update courses only, BCH employees are offered the use of a manual from our library system up to 1 month in advance of your scheduled course date. To borrow a manual please contact the office x52649. *All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* June 21, 2023 June 30, 2023 July 13, 2023 July 19, 2023 - Waltham July 21, 2023 July 31, 2023 August 7, 2023 August 11, 2023 August 18, 2023 August 28, 2023 August 30, 2023 September 6, 2023 September 13, 2023 September 15, 2023 September 20, 2023 - Waltham September 25, 2023 September 28, 2023 PEARS ProviderPlease choose 3 dates and use the special instruction box to list choices in order. When you only choose 1 date this holds up the process of getting you seated and you may have to fill out a new form. Once confirmed into a course, there is an administration fee for date changes and cancellations. . *All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* September 27, 2023 Select AllTraining Dates- ACLS Provider Course*Please choose 3 dates and use the special instruction box to list choices in order. When you only choose 1 date this holds up the process of getting you seated and you may have to fill out a new form. Once confirmed into a course, there is an administration fee for date changes and cancellations. *All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* All 3rd quarter dates have filled. We do not accept forms without available dates. Watch for the release of 4th quarter dates in July 2023. Training Dates - ACLS Update Course*Please choose 3 dates and use the special instruction box to list choices in order. When you only choose 1 date this holds up the process of getting you seated and you may have to fill out a new form. Once confirmed into a course, there is an administration fee for date changes and cancellations. TEXTBOOKS: For Update courses only, BCH employees are offered the use of a manual from our library system up to 1 month in advance of your scheduled course date. To borrow a manual please contact the office x52649. *All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* July 20, 2023 - Waltham August 17, 2023 - Waltham September 26, 2023 Upload a copy of your current Certification Card (only if you did not take your last course @BCH)Max. file size: 64 MB.Name*As you would like it to appear on card First Last RN, MD, PNP, Other:* Status (employees only)* Full time Part time (cover by dept of nursing if you have a reg 20hr. schedule) Per diem (not covered by dept of nursing) Travel (not covered by dept of nursing) Email*You must make sure to use your professional BCH email address, if you have a name change please make sure to use the correct BCH email address. Phone*Home Address (business addresses are not accepted)* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Are you a Boston Children's employee or affiliate?* Yes No Do you require BLS CPR with your course? (To add post submission there is $25.00 admin fee)* Yes No BCH Employee ID #* Unit/Floor* Special Instructions. Use this section to place class dates in order of choice. Will your department be covering the cost?If you are covering the cost of your course you must call the office at 617-355-26449 ( or ext 52649) to submit payment before we are able to process your request. Yes No Payment - Department ID# and Approving Managers name*We are unable to process without your department numerical number and approver name. PaymentFor security purposes; before registration can be processed self-paying participants must contact the office 617-355-2649 during normal business hours Monday through Friday 7:00am- 3:30pm to make payment CommentsThis field is for validation purposes and should be left unchanged. Δ