Progressive Rescue Solutions, Inc., Mountain Rope Safety

General Registration for Rope Rescue Courses
Name:______________________________ HM. Phone: ____________________________________________
Home Address: ________________________________________________________________________________
______________________________________________________________________________________________
Age: ___________________ E-Mail:______________________________________________________
Agency: ___________________________ Phone: _______________________________________
Class (es) & Date (s) of Class (es) registering for: _______________________________________
_______________________________________________________________________________________________
Payment Method: Check or Bill Me (please circle one)
Class fees must be paid in full 30 days or more before course. Full refunds are available minus a $25.00 registration fee, up to 30 days before course. For
cancellation less than 30 days notice, we will be happy to accept another person in your place, or transfer your entire registration to another PRS, Inc. course
within one year. Occasionally due to circumstances beyond our control, we must postpone or cancel courses. If so, we are liable only for full registration fee.
Please send registration and payment to Pat Wagner 410 Miles Road, Signal Mtn., TN. 37377
Phone: (877)889-3804 Fax: (423)886-7621 E-Mail: PWagner410@Comcast.Net
Class sizes limited so first paid and registered will be in course. Information concerning course location, maps and housing will be
mailed upon receipt of registration and payment for course. Classes scheduled for Signal Mtn., TN. unless someone has 12 or more
students in their area in need of training. Call if you need a class scheduled for your organization.