Private Registration
Form

IMPORTANT

Please read the following before you continue:

This form is specifically for agencies who have ALREADY been in contact with our administration team and have a course scheduled on our upcoming calendar.

If you are looking to inquire about setting up a private course, please visit our host a course page or contact us directly.

HOST A COURSE

Private Registration Form

Company
This field is for validation purposes and should be left unchanged.
Private Agency Registration
Agency or Name
Course Type
Course Date
Phone
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Names of Attendees
First Last Email
Total number of Attendees
(For courses outside of Missoula, MT) Please list the height and weight of each person needing a wetsuit
Height Weight
(For courses outside of Missoula,MT) Please list shoe sizes of each person needing footwear
Payment
For agency billing, net 30 invoice will be sent after course completion
Cancellation Policy
To receive a full refund cancellation must occur 2 weeks prior to your course start date. If cancellation occurs after that 50% of your estimated course cost will be due or $2000.00, whichever is greater.
Indemnity
Except for the Whitewater Rescue Institute’s (WRI) grossly negligent or intentionally wrong acts, the Hosting Agency agrees to indemnify and protect WRI from any and all claims and liabilities, from participants or from any and all claims arising in whole or in part from participants’ conduct, whether personal injury, property loss, contract or under any other legal theory, however, such a claim or liability may arise. Indemnity includes payment or reimbursement of costs, including attorney’s fees, and payment of all damages. The substantive laws of the State of Montana shall govern any dispute between WRI and the Hosting Agency, and any mediation or suit shall occur or be filed only in the State of Montana. Please review the above information. If the above information matches your expectations, please e-sign below.
Signature*
By e-signing, you as an authorized representation of your organization do hereby acknowledge and commit to hosting and reimbursing WRI for the course(s) as detailed above through my signature at the bottom of this form.

First	Last	Email

Height	Weight

Private Registration Form

** IMPORTANT**

Please read the following before you continue:

Private Registration Form

Private Agency Registration

Payment

Cancellation Policy

Indemnity

Private Registration
Form

IMPORTANT