Course Registration Form

Completely fill out and submit the following form. Your registration request will be processed by our office, usually within 2–3 business days, after which a confirmation e-mail with details pertinent to your course such as directions and what to bring. Your credit card is typically authorized for the tuition amount when this form is submitted.

Please Note: This form MUST be completed by the person attending the course or trip, or the parent or legal guardian of a minor.

ALL fields are required, unless otherwise noted.

Course Information


Client Information

(Be sure to use an email address that you regularly monitor- ALL correspondence and course materials will be sent to this email address.)


Course Materials

Textbook shipping costs are included in 5 Day WFR tuition ONLY. All other courses must add $9 to tuition (below) for OPTIONAL textbook shipping.

For 5 Day WFR or those who request pre-course text shipping:

Where do you want your textbook to be shipped?

Standard shipping method applies to US locations only, and takes 2-7 business days for delivery. Be sure to contact our offices for a more rapid delivery method if you are registering close to a registration deadline, or for shipping addresses outside the US. (Additional shipping costs will apply.)


Medical Information

 

Adventure Risk Management requests this information to assist any care provider in the management of medical conditions that any participant may have. This information will remain protected and confidential. Adventure Risk Management makes no pre-event determination of fitness or ability to participate in any activity, course or training, and strongly recommends that all participants discuss these activities with their physician prior to arrival at the event. We will be happy to provide more information to you or your physician regarding the requirements for participation.

Adventure Risk Management operates in outdoor, sometimes remote, wilderness locations. Depending on course type, clients may carry 25-50 lb. packs, hike 2-5 miles a day, at higher elevations. Potentially harmful animals, vegetation or people may be encountered. On overnight courses or trainings, participants may sleep outdoors and prepare their own meals. Weather conditions can vary greatly: temperatures from below freezing to over 100ºF, rain and snow storms, high winds and intense sunlight are possible. Prior conditioning is strongly recommended. On all courses or trainings, participants are expected to take responsibility for their own safety. Please consider the above description carefully as you complete this section.

Please list any relevant medical or psychologic conditions that you are currently managing or have had in your past (Enter 'None' if not applicable):

Note: The following list is a non-exhaustive list of conditions that may be pertinent: musculoskeletal injuries, cardio-respiratory system problems, neurologic conditions, allergies (environmental), blood sugar management, heat or cold injury…

Please list any medications that you take on a regular or periodic basis, and the typical dosage (Enter 'None' if not applicable):


Policy Agreements

Please read this policy carefully, as it will apply to your registration!


Payment Information

STOP!

If you are using a credit or debit card that is not in your own name, the person named on your payment method MUST provide authorization to use that credit card. This authorization must be provided by that person completing the form at this link:

http://adventureriskmanagement.com/wilderness-medicine/enrollment-info/tuition-payment-form/

Be aware that until both your Registration Form AND this Payment Authorization is received, your registration cannot be processed & confirmed.

Text shipping fee is INCLUDED in 5 Day WFR tuition ONLY. All other courses add $9 for OPTIONAL textbook shipping.

Add $30 if your registration is submitted within 14 days of Day 1 of your course.

Total amount to charge: $0.00

CAREFULLY enter the following information. Errors will result in a delay of processing.

Digits only- no spaces or hyphens. Type carefully!

Expiration Date


Billing Address


Registration, Cancellation and Transfer Policy
Read this Policy carefully- regardless of the nature of your cancellation or transfer request (illness, injury, family emergency, work responsibility, etc.) the terms of this policy will apply to your Registration!

The Adventure Risk Management Registration, Cancellation and Transfer Policy is based upon our goal to deliver quality, well-planned courses for our clients. Late cancellations and transfers place courses at risk of cancellation, creating hardship and frustration for other registered clients. Further, once a client is confirmed on a course, Adventure Risk Management incurs multiple expenses that cannot be recovered after a cancellation.

Registration: All courses require full payment to reserve a space. All registered participants must be 18 years of age to participate in a course, or the parent or legal guardian must be present throughout the course. Registration Requests received within 14 days of Day 1 are subject to a $30 Late Registration fee. Adventure Risk Management reserves the right to decline any Registration Request.

Transfer or Cancellation (5 Day WFR only):

  • 30 days or more prior to Day 1 of your course: Cancellations or transfer request will be subject to a $75 processing fee, per registration.
  • 15 days to 30 days prior to Day 1: 50% tuition refund or transfer credit. Transfer credits must be used within six months of original course.
  • 14 days to 48 hours prior to Day 1: Cancellation or transfer requests result in 100% forfeiture of tuition.
  • If you are able to find another person to fill your space, there will be a $75 processing fee (per registration).

 Transfer or Cancellation (Courses other than 5 Day WFR):

  • 15 days or more prior to Day 1 of your course: Cancellations or transfer request will be subject to a $75 processing fee, per registration.
  • 14 days to 48 hours prior to Day 1: 50% tuition refund or transfer credit. Transfer credits must be used within six months of original course.
  • 48 hours or less prior to Day 1: Cancellations or transfer requests result in 100% forfeiture of tuition.
  • If you are able to find another person to fill your space, there will be a $75 processing fee (per registration).

Course Textbook costs
If you cancel your registration, the cost of any course textbook (plus shipping fees) that you may have received pre-course will be in addition to any cancellation processing fees. In the event that your course cancels for any reason, you will be responsible for the cost of any textbook(s) that were mailed to you prior to your course. To avoid these costs, any textbook must be returned to us within one week of a cancellation notification, and must be in absolutely new, re-usable condition. (As of December 2015, 'Wilderness and Rescue Medicine' cost is $45. 'Outward Bound Wilderness First Aid Handbook' is $15.95)

Eligibility, Course Participation, Certification
You are responsible to ensure your own eligibility for any course (i.e. Recertification or Bridge courses) prior to your arrival. No refunds or credits will be issued for any of the following circumstances:

  • Ineligibility for Recertification or Bridge courses.
  • Ineligibility for certification due to tardiness or absence (100% attendance is required to be eligible for certification).
  • Early departures or no shows.
  • Failure of course for any reason.

Course Policies
In the interest of a healthy, conducive learning environment, all students are expected to adhere to the following Course Policies:

  • There is no smoking in any of the buildings. Smoking is allowed only at designated outdoor sites.
  • Minors must have their parent or legal guardian present with them throughout the course.
  • There are no pets allowed at any course. Pets may not be left in vehicles during a course.
  • Please refrain from all alcohol or drug use at any time at the facilities where this course is conducted.
  • Your personal items are your responsibility- take reasonable precautions in securing your personal items. Adventure Risk Management will not be responsible for lost or stolen items.

Adventure Risk Management reserves the right to dismiss any student from a course due to violation of any course policy or disruptive behaviors, with no refund or transfer credit.

Course Cancellation
Though uncommon, Courses or Events may be cancelled for reasons outside of the control of Adventure Risk Management (i.e. low enrollment, weather, etc.). In the event of such cancellation, you will receive a full refund, or you may transfer to another Course with no additional fee. Adventure Risk Management will not be financially responsible for any client travel or lodging expenses, or for any other client preparations made for a Course or Event.

©2017 Adventure Risk Management

Please note: By submitting this Registration Request, you have agreed to the terms of the Registration, Cancellation and Transfer Policy.


Registration, Cancellation and Transfer Policy


Registration, Cancellation and Transfer Policy Read this Policy carefully- regardless of the nature of your cancellation or transfer request (illness, injury, family emergency, work responsibility, etc.) the terms of this policy will apply to your Registration! The Adventure Risk Management Registration, Cancellation and Transfer Policy is based upon our goal to deliver quality, well-planned courses for our clients. Late cancellations and transfers place courses at risk of cancellation, creating hardship and frustration for other registered clients. Further, once a client is confirmed on a course, Adventure Risk Management incurs multiple expenses that cannot be recovered after a cancellation. Registration: All courses require full payment to reserve a space. All registered participants must be 18 years of age to participate in a course, or the parent or legal guardian must be present throughout the course. Registration Requests received within 14 days of Day 1 are subject to a $30 Late Registration fee. Adventure Risk Management reserves the right to decline any Registration Request. Transfer or Cancellation (5 Day WFR only):

 Transfer or Cancellation (Courses other than 5 Day WFR):

Course Textbook costs If you cancel your registration, the cost of any course textbook (plus shipping fees) that you may have received pre-course will be in addition to any cancellation processing fees. In the event that your course cancels for any reason, you will be responsible for the cost of any textbook(s) that were mailed to you prior to your course. To avoid these costs, any textbook must be returned to us within one week of a cancellation notification, and must be in absolutely new, re-usable condition. (As of December 2015, ‘Wilderness and Rescue Medicine’ cost is $45. ‘Outward Bound Wilderness First Aid Handbook’ is $15.95) Eligibility, Course Participation, Certification You are responsible to ensure your own eligibility for any course (i.e. Recertification or Bridge courses) prior to your arrival. No refunds or credits will be issued for any of the following circumstances:

Course Policies In the interest of a healthy, conducive learning environment, all students are expected to adhere to the following Course Policies:

Adventure Risk Management reserves the right to dismiss any student from a course due to violation of any course policy or disruptive behaviors, with no refund or transfer credit. Course Cancellation Though uncommon, Courses or Events may be cancelled for reasons outside of the control of Adventure Risk Management (i.e. low enrollment, weather, etc.). In the event of such cancellation, you will receive a full refund, or you may transfer to another Course with no additional fee. Adventure Risk Management will not be financially responsible for any client travel or lodging expenses, or for any other client preparations made for a Course or Event. ©2017 Adventure Risk Management

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Wilderness Medicine Course Tuitions

Wilderness Medicine courses

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Verification of Accuracy and Full Disclosure Statement

I understand and acknowledge that Adventure Risk Management is not making a determination of my fitness for a course, training or event; rather, I represent to Adventure Risk Management and verify that I am physically fit and ready for the course, training or event.

I understand and acknowledge that my failure to disclose relevant information may result in harm to myself and others during a course, training or event. I agree to indemnify and hold harmless Apogee Endeavors, LLC dba Adventure Risk Management (hereafter referred to as ‘Adventure Risk Management’) and its affiliates, members, officers, employees, independent contractors and other agents from any claims I may make for personal injuries or death to myself and from the claims of third parties whose injury or death I may have contributed to or caused as a result of my failure to disclose any such information.

   I represent and warrant that I have provided all material and important information to Adventure Risk Management pertaining to my medical, mental, and physical condition, in view of my participation on a course or training. I agree to notify the Lead Instructor if there is any change in my physical, mental, or medical condition prior to my scheduled course or training. I further represent and warrant that this information is complete and accurate.

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Parent or legal guardian is required to be present at all courses.

Due to insurance regulations and the policies of facilities where our courses are provided, all minor students (less than 18 years of age at the time of the course) must have their parent or legal guardian present, attending as a fully-registered student.

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John Jacobs Background

20070118_WMA_0003_lowres_cropWilderness Medicine Instructional Experience

 

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Outdoor Education Industry Experience

Rescue & Emergency Medicine Experience

Other Outdoor Industry Experience

IMG16_CropOutdoor Recreation Interests & Experience

Mountain adventure sports have been a central part of John’s entire life. He is well-versed in all disciplines of climbing including mountaineering, traditional & sport climbing, ice climbing, bouldering in locations across Western North America including Alaska, Coast Range, Cascades, Sierra Nevada, Southern California, and Mexico. In addition to his climbing interests, he has done extensive long-distance hiking, and backcountry skiing. A few of his notable achievements include:

Climbing

Hiking

Backcountry Skiing

 

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Bill 'Jobi' Hanson Background

JobiHanson1Bill ‘Jobi’ Hanson has been an EMT since 1989, and a Paramedic since 2000. He began his career in pre-hospital medicine as a combat medic for the US Army. Since then he has worked urban EMS in Boston and rural EMS in Vermont, Oregon, and Colorado as well as on a professional ski patrol, on a critical-care transport service, and as a Flight Paramedic on the Navajo reservation in Arizona.  Jobi also worked for several years as a wilderness educator, rock-climbing guide, and program director for Outward Bound and similar organizations with groups ranging from juvenile offenders to corporate executives.  Currently he works as a Helicopter Rescue Specialist and Crew Chief for Travis County STAR Flight in Austin, Tx. In his spare time he rock-climbs, paddles, scuba dives, and trains for triathlons. 

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Deb Ajango Background

DebAjangoDeb Ajango has instructed for Wilderness Medical Associates International for more than a dozen years. She lives in Alaska and has traveled the state extensively. Besides teaching classes for WMA, she owns and operates a business in outdoor safety. Deb’s claim to fame is that she and her husband have actually been attacked (and husband mauled) by a grizzly bear.

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Ben Dowdy Background

BenDowdyBen Dowdy has been involved with the outdoors since childhood, and in EMS since 2003. He has worked in eastern Kentucky as a paramedic, tactical medic, and EMS educator. In 2012, he worked in Yellowstone National Park as a paramedic. In addition to teaching all around the US for WMA, Ben is involved with Eastern Kentucky University’s paramedic program and performs SAR and technical rescue in the Red River Gorge area. When not working for SOMEBODY, he racks up plenty of trail and rock time in the southeastern US.

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