Open and Complete Application Form
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Mail with Payment Payable To: |
Ralph Panaro |
Payment is non-refundable without a two week notice of cancellation - money can be applied to any future course within 1 year.
| Email: | Ralph "Turtle" Panaro | Application Form | Pay Ralph Panaro now with Pay Pal! |
Course Information
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Course Name: |
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Course Date: |
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Personal Information
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Name: Address: City, State, Zip
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Phone: Cell:
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Email Address: |
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Date of Birth: Occupation:
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Where did you hear about this school?
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Payment for deposit: A $75.00 deposit is due at the time of registration. Please include money order or check. |
Payment Information
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Payment Method: |
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Money Order |
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Check |
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Travelers Check |
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Postal address |
Pay Pal |
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Waiver
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In all classes, demonstrations and excursions conducted by Red Tail Primitive Skills, LLC, reasonable care is taken to prevent serious injuries and to minimize accidents. The PARTICIPANT states that he/she is fully aware that survival and awareness training, even under the safest conditions possible, may be dangerous and the PARTICIPANT hereby agrees to accept full responsibility and assume all risks, including those caused by acts of God, injury, death, and/or loss to his/her person and/or property knowingly and voluntarily. The PARTICIPANT understands that said training may include the use of and training with firearms and/or other hazardous tools or weapons. The PARTICIPANT agrees to obey the rules and regulations that Red Tail Primitive Skills, LLC puts into effect to minimize these risks. The PARTICIPANT knowingly, voluntarily, and irrevocably waives any and all past, present, and/or future injuries, death, or loss, including those caused by acts of God, received while participating in activities conducted by Red Tail Primitive Skills, LLC as a student, participant, spectator and/or visitor, or in any other manner or form, taking part in the exercises, practices, excursions, and/or demonstrations of awareness and survival training. The PARTICIPANT certifies that he/she is physically capable to participate in said awareness and survival training programs despite the rigors and dangers inherent in such an undertaking, including the use of firearms. The PARTICIPANT accepts all responsibility for any injury, death, and/or loss to his/her person or property, including by acts of God, for the rigors and dangers inherent in this undertaking. Signed:________________________________________________________ Date: ________________________________________________________
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