Please complete the registration form below. This will provide us the information that is needed to get you registered for your class. Your Name (required) Your Email (required) Department/Company (required) Address (required) City (required) Zip Code (required) Department/Company Phone Number (required) Home/Cell Phone Number (required) Department Contact (required) Department Contact Phone Number (required) Department Contact Email (required) Course Agency Type(required) State Fireman's Fire Marshals AssociationTexas Commission on Fire ProtectionOther Course Selection (required) Driver/Operator - PumperFire InvestigatorFire Inspector / Fire Prevention SpecialistsFire Instructor IFire Instructor IIFire Instructor IIIFire Officer IFire Officer IIFire Officer IIIFire Officer IVIncident Safety OfficerIntroductory FirefighterFirefighter IFire Fighter IIContinuing Education TCFP Pin Number (required) If you do not have one please type in I need one. If you are taking this under SFFMA please type in SFFMA. Payment Type(required) Purchase OrderCredit CardCheckCash Liability Release: In consideration for receiving permission to participate in a class instructed by SAFET, I hereby release SAFET, their agents, officers, employees from any and all liability, claims, cost, and causes of action arising out of or related to any property damage or personal injury, including death, that may be sustained by me, while participating in such activity. I understand that SAFET does not maintain any insurance policy covering any circumstances arising from my participation in the activity or any event related to that participation. In signing this release, I acknowledge that I have read and understand the release: and I am at least 18 years of age and fully competent. By registering for this course I give SAFET permission to reproduce and publish my name and/or photographic likeness. Transfers: SAFET has a Pro-rated Refund policy. If you contact SAFET prior your start date you may have the option to transfer your registration to another class of the same course. If the same course is not available then you may apply the in-school credit to any class of your choosing. If the newly chosen class is of greater value than the credited amount then the additional tuition and fees will need to be paid prior to the start of the chosen class. Cancellations: SAFE-T will provide a full refund if you cancel 15 or more calendar days before the start of your scheduled class. Cancellations received 14 days or later will only be refunded at the rate 70%. Any cancellations received 5 days or later will only be refunded at the rate of 50%. No-Shows: Participants who do not contact SAFE-T in advance to cancel their registration and do not attend their scheduled class will be charged the entire class fee. Your Acceptance of our Terms (required) I agree to the terms of this registration form If this form does not send, please contact John ja9097@jdaw.net