CPR Training, Ozaukee County Special Olympics

CPR Training, Ozaukee County Special Olympics

Name: Anthony F. Werth Jr
Email: awerth@ravenswoodclinic.org
Phone: 1-414-630-1186
Address/Library Card # (prove residency): W67 N704 Franklin Ave
Group/Fee Category: non_profit_resident
Org. Name & Address: W67 N704 Franklin Ave, Cedarburg, WI 53012
Your Event Name: CPR Training, Ozaukee County Special Olympics
Description of Your Event: CPR/DEFIB training for volunteer coaches in Special Olympics. Non profit organization.

Approved by Gemma. Sent email for further details on room set up and to let them know they can only get in at 9:30am.

Community Room Event Questionnaire

For Public and Private Event Set-up – Please complete fully to help us prepare for your event.

Event Basics

1. Event Name: CPR Training, Ozaukee County Special Olympics

2. Hosting Group/Organization Name: Ozaukee County Special Olympics

3. Estimated Number of Attendees, if known:[Anthony F. Werth Jr., MS, LPC, SAC, ICS] 10 to 15 participants.

4. Is the group a non-profit organization? YES

5. Is the applicant a resident of the City of Cedarburg? YES

Date & Time

6. Preferred Date(s) and Time(s) for the Event: Saturday December 20, 2025 from 9:30am to 2:00pm.

(Include start and end time, plus any time needed for setup/take-down)[Anthony F. Werth Jr., MS, LPC, SAC, ICS] Set up at 9:30. Session at 10. We will be done around 1:30ish.

Event Description

7. Brief Description of the Event:
(Include purpose, target audience, and general activities planned)

CPR/DEFIB training for volunteer coaches in Special Olympics. Non profit organization.

Contact Information

8. Main Contact for the Event:

Name: Anthony F. Werth Jr

Email: awerth@ravenswoodclinic.org

Cell Phone (for day-of contact): 1-414-630-1186

Room Set-up

9. Preferred Room Layout:
(Please select one or describe your setup needs)

Small Group Tables[Anthony F. Werth Jr., MS, LPC, SAC, ICS] This will work .

10. Will your group handle the room set-up?
[Anthony F. Werth Jr., MS, LPC, SAC, ICS] We will handle set up and clean up.

Technology Needs

11. What technical equipment will you need?[Anthony F. Werth Jr., MS, LPC, SAC, ICS] The American Red Cross is teaching When they tell us what is needed, I will inform you.
12. Will you need staff assistance with technology on the day of the event?[Anthony F. Werth Jr., MS, LPC, SAC, ICS] No
Refreshments

13. Will your group provide refreshments?[Anthony F. Werth Jr., MS, LPC, SAC, ICS] Drinks, no food.