Wright Rescue Solutions, Inc.

Open Enrollment Course – Registration Form

First Name

Middle Name

Last Name

Organization

Title

Mailing Address:

City:

State:

Zip:

Shipping Address:

City:

State:

Zip:

Daytime Phone Number

Nightime Phone Number

Alternate Phone Number

Email Address

Which course(s) are you registering for?

Confined Space & Structural Rope Rescue - Operations Level - No pre-requisite

Confined Space & Structural Rope Rescue - Technician Level - Pre-requisite: Operations Level

Confined Space & Structural Rope Rescue - Advanced Level (Tech) - Pre-requisite: Technician Level

Full Class - 45 Hours

Dates:

Registration Fee:$700

Confined Space & Structural Rope Rescue - Ultimate - No Pre-requisite - Combines Ops, Tech & Advanced

Full Class - 45 Hours

Dates:

Registration Fee:$1,800

Confined Space & Structural Rope Rescue - Qualified Rescue Instructor I - Pre-requisite: Technician Level

	Refresher - 54 Hours	Dates:	Registration Fee:$750
	Full Class - 88 Hours	Dates:	Registration Fee:$1,200

Firefighter Self-Rescue Classes - Pre-requisite: Volunteer or Career Firefighter - Full Bunker Gear Required

	Escape - 8 Hours	Dates:	Registration Fee:$150 Petzl EXO End-user Qualification
	Survival & Escape - 16 Hours	Dates:	Registration Fee:$300 EXO, Escape Artist, RT Device

Vehicle & Equipment Rescue - No Pre-requisite - Full Protective Gear Required

	Operations Level - 40 Hours	Dates:	Registration Fee:$600 Hosted by Rescue Systems
	Technician Level - 40 Hours	Dates:	Registration Fee:$700 Hosted by Rescue Systems