Class Registration Form

Class Registration Form

Please fill in the form below and don't hesitate to contact us with any questions that you may have. Your spot in a class is not secured until we receive the total amount for the class. Payments can be made through this form or by a check in the mail. If you would like to pay by check, please use the contact form on my website to let me know and I will send you the address.
Please select a class/ event to register for*
Yes (If so, please explain in the "Other" option below)NoOther
Student's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student's Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Questions about the class

My Products*

Emergency Remain Over Night 1 (ERON 1) 18-19 November 2023 (Adult)

18-19 November 2023 at First Magnitude Wilderness Programs (Campton, NH). Camping Fee and Shelter Materials Included.

$229.00 Quantity

Emergency Remain Over Night 1 (ERON 1) 18-19 November 2023 (Child: ages 12-17)

18-19 November 2023 at First Magnitude Wilderness Programs (Campton, NH). Camping Fee and Shelter Materials Included.

$74.00

Emergency Remain Over Night 1 (ERON 1)

Private Course. Camping Fee and Shelter Materials Included.

$229.00 Quantity

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Subtotal

$0.00

Tax

$0.00

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.