Crested Butte Outdoors, LLC

 Course Registration Form

2010

Please print and fill out this form, sign the bottom of the form, and mail your payment to:

 

Crested Butte Outdoors, LLC

P.O. Box 5533
Whitefish, Montana 59937

  Please reserve my space for the following course:  (Check the course that applies) 

Wilderness First Responder  7 Day

Wilderness First Responder

5 Day

 Wilderness EMT Upgrade

Wilderness First Aid

WFA

Whitefish Mountain Resort

Whitefish, Montana

January 10-14, 2011

$695.00

   Flathead Valley Community College  Kalispell, Montana

November 15-19, 2010

$650.00 www.fvcc.edu

 

 

 

 Whitefish, Montana

To be announced

 

  

Flathead Valley Community College  www.fvcc.edu $225.

October 7-8

November 4-5

December 1-2

 
Whitefish, Montana

October 12-16, 2010

 

 

  

 

Open Recert Whitefish, MT

To be announced
   

 
   

 

 

Student Name:                           

Occupation:

Street Address:

 Age:

City:

 E-mail

State and Zip Code:

Phone (day)                                                     

(Evening)

 

 

Enclose a check payable to Crested Butte Outdoors, LLC for the appropriate course.  We will accept deposits equal to 50% of the full course price. A full refund, minus a $100cancellation fee, will be issued to any student canceling if more than 31 days remain before the start of the class.  No refunds will be issued within 31 days of the class start date.  In the unlikely event that a course is canceled, a Full refund will be issued.

 

WFR ($695)     |    Wilderness First Aid ($225)   |  WEMT ($695)

I have read and understand the terms and conditions set forth in the Wilderness Medical Associates Course Participation Standards and the Participation Release and Indemnity Agreements. 

Student Signature

Date