Boot Camp Registration Form

Safety Training Boot Camp Registration

Company Name:

Address / Street *

City: *

State *

Zip Code *

Your First Name: *

Your Last Name: *

Your Email Address: *

Business Phone Number: *

Cell Phone Number: *

Position with Company: *

Safety Training Boot Camp - $1,295.00 per student

Five (5) consecutive 10 hour days. At the end of the 5 days students will be trained in the following:

OSHA 30 HR (1926, OSHA completion card, no testing required)
First Aid / CPR / AED (certification)
Fall Protection (certification)
Confined Space for Construction (certification)
Silica Awareness (certification)
Ladder Safety (certification)
Excavation (certification)
Industrial Powered Trucks (Forklit certification)
- Variable Reach & Warehouse
Aerial Lift (certification)
Scissor Lift (certification)

Each student registered will be required to complete approximately 12 hours of online training assignments (emailed to them upon paid registration). This is required to save time so hands-on operating evaluations can be completed. Registration will close 15 calendar days prior the 1st day of class.

Included in the Safety Boot Camp

One (1) year FREE access to Safety Assured online training platform. Over 100 training modules with online certifications valued at over $2,500. See list of training modules per the tabs at bottom of spreadsheet here

Amazon Fire 7 tablet loaded with the OSHA 30 hour training for your reference

Safety Assured will provide: Contintial Breakfast, Lunch, Afternoon snacks each day.

Below is information required for each student you register. Each student must have a current and active email address for emailing pre-assigned courses. All classes are limited to 30 students per class and must be registered through our website to aquire complete and accurate registraion information.

The Boot Camp registration fee of $1,295 per student is due upon registration. Cancellation requests less than 15 business days prior to the 1st day of class are non-refundable. Students will be placed in a future class if they cancel or “no show” with less than the 15 calendar day written notice no exceptions. All other written cancellation requests before the15 business days will be refunded back to the orginal credit card only. All cancellation requests must be emailed to: admin@safetyassuredllc.net and put CANCELLATION REQUEST in the subject line. Cancellation requests by others means will not be accepted. Safety Assured reserves the right to cancel a Boot Camp if the minimum number of registrants is not met. You will be notified by email if this occurs and have the option to a full refund or to move your registration to a different Boot Camp. You are welcome to contact us by email at admin@safetyassuredllc.net any time to check the status of a Boot Camp.

Student by registering is agreeing they will attend the entire 50 hours of Boot Camp plus complete the 12 hours of onlline training no later than five (5) days prior to class. Attending less than the 50 hours of Boot Camp and not completing all the online training required will disqualify them from completing the OSHA 30 Hour, and obtaining certifications in Forklift(s), Aerial Lift, Scissor Lift and First Aid / CPR / AED as these require hands-on evaluations. There will be NO exceptions to this requirement.

Please select your choice of registering students * 🛈

I will enter each student 1-30 (who will be attending the class on the dates selected)

Only student attending is entered above

Student No. 1

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address * 🛈

Which Safety Boot Camp Would the Above Student be Attending? *

Jun 8 -12, 2020 Monday-Friday (30 seats remaining)

Jul 23-27 2020 Thursday-Monday (30 seats remaining)

Aug 24-29 2020 Monday-Friday (30 seats remaining)

Sept 17-21 2020 Thursday-Monday (30 seats remaining)

Oct 26-30 2020 Monday-Friday (30 seats remaining)

Add Student No.2 *

Yes

No, I am done