Class/Event Registration Fill out the form below to register for this event! Name: Email: Address: Phone: Event/Course: Event Date: Time of Event: Are you a Mercy Hospital employee? YesNo How did you hear about the workshop? Mercy Hospital's WebsiteMercy Hospital's Facebook PageMercy Hospital Newsletter (LifeLine, Mercy Beat)Online SearchOther If there is a fee for the course, how would you like to make payment? Online paymentSend check to Mercy Hospital Education DepartmentOther / Not Applicable Please leave this field empty.