Crested Butte Outdoors, LLC

Colorado Course Registration Form

 

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 (WFR)

Wilderness EMT Upgrade

Open Recertification

Course

Wilderness First Aid

April 12th - April 19th

   June 2nd - June 6th

 

 April 25th - April 27th    

 
May 19th - May 25th   May 29th - May 31th  
   

 
   

 

               

 

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 $75 cancellation fee, will be issued to any student canceling if more than 30 days remain before the start of the class.  No refunds will be issued within 30 days of the class start date.  In the unlikely event that a course is canceled, a Full refund will be issued.

 

WFR (/$650)     |    Recertification/Challenge Course ($350)   |  WEMT ($675)includes lunch

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