Primitive Skills Survival School Registration

To attend a course it is necessary to fill out a separate Registration form below for each class or workshop. When done click Send Form and a payment page will open. You may then pay by Paypal, Check, or Money Order. A 50% non-refundable deposit is required within one week after you complete your registration form. A deposit is required to hold a space for you in a course. See payment page for details.

All courses except for the children programs are for adults age 18 or older. If you have any questions regarding this email mpss@gwi.net.

Contact Information

Name:

Address:

Phone:

Email:

Emergency Information

Emergency Contact:

Relation to Student:

Phone:

Existing Medical Conditions:

(allergies, injuries, etc.):

Course Information

Please fill out a registration separately for each course taken

Course Name:

Course Location:

Course Date:

Comments

Liability Waiver

By responding below I agree to everything stated in the following paragraph. I accept full responsibility and assume all risks during my time spent at the Maine Primitive Skills School. I agree to follow any rules set by the Maine Primitive Skills School staff and use common sense in order to minimize risks. I knowingly, voluntarily and irrevocably waive any and all past, present, and/or future claims on the Maine Primitive Skills School and its staff, fiscal or otherwise, of injuries, death, and/or loss of property while attending said school. I certify that I am physically and mentally capable to participate in the activities at the Maine Primitive Skills School. I understand that there are inherent risks present in the Maine Primitive Skills School programs, and it is my decision as to whether I participate in them or not. I also recognize that there are hazards associated with the consumption and/or use of plant or animal matter that may result in sickness or death. I give my permission for the Maine Primitive Skills School staff, or any qualified medical personnel to provide medical assistance as necessary. Further, I give permission for the transportation to and from such treatment by the Maine Primitive Skills School staff or emergency personnel.

I have read, understand, and agree to the liability waiver above and

Payment Type