Registration:

You may fill out the form below and click the submit button to send this form instantly via the Internet, or feel free to
download this same form in Microsoft Word by clicking HERE. You may fill out and email the Word Document to us
or print it out and hand mail to us. Either way you choose, we are glad you decided to contact us!


Your Name:


Phone Number:


Cell:


Your Age:
Your EMail:


Contact Person Name:


Contact Person Phone:


Agency:
Class(es) & Date(s) of class(es) you are Registrering for:


How would you like to pay:
Check will be mailed to the address below | Bill Me
If paying by check, please make checks payable to: Mountain Rope Safety Courses

Fee categories are listed on schedule: Individual TARS members may submit a copy of their membership card, applicants belonging to TARS Associate agencies must list their agency name above and understand their agency must be on the current TARS listing to qualify for fee category two.

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 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 Mountain Rope Safety Courses: 410 Miles Road, Signal Mountain, TN. 37377

Phone Toll Free: (877)889-3804 Fax: (423)886-7621 Local: 886-3804

E-Mail: PWagner@MountainRopeSafety.com or 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.



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