Pediatric Advanced Life Support (PALS) Registration Form

Registration Information

  • Preregistration is required in person, by phone, or submitting this online form.
  • Registration must be received at least ten (10) days in advance of class to allow for materials to be mailed and reviewed by participant.
  • Your packet will include a pretest that must be completed before class begins.
  • Tuition includes the American Heart Association Provider textbook.
  • Cancellations - One class rescheduling is permitted with notice of unavoidbable circumstances.

Please complete this form and select a payment option below. Payment options:

  • Credit card by completing registration online or faxing this completed page to 757.446.5906
  • Check (complete form, print page and mail along with payment to:
    Tidewater Center for Life Support Training - 145
    Eastern Virginia Medical School
    358 Mowbray Arch, #103
    Norfolk VA 23507