Western Montana School for Guides

  

WMSG
PO Box 733
Darby, MT 59829
1-406-821-0017
   
   
   

ENROLLMENT APPLICATION

(Please Print, then make Photocopy of Completed Form for Your Records.)
     
       
Date of class you wish to attend (refer to Enrollment Information): ___________________________________
     
Name: _________________________________________________ Phone: (______) _________________
     
Address: _______________________________________________Social Security No ________________
     
City:  ______________________________________________________ State: _______ Zip: ___________
     
Age: _______________ Weight: ______________ Height: ______________ Do you have any physical disabilities/problems: Y  N
 
If yes, please describe disabilities: ___________________________________________________________________________________
 
Describe any medication you currently take: ___________________________________________________________________________
 
Identify any food allergies: _________________________________________________________________________________________
 
Have you ridden horses: Y  N  Where and when: _______________________________________________________________________
 
Have you hunted big game:  Y  N  Type of game and results: ______________________________________________________________
 
_______________________________________________________________________________________________________________
 
4-WEEK TRAINING PROGRAM  I agree to pay $3500 to the Western Montana School for Guides.  Enclosed is the deposit of $1500, the balance of $2000 will be paid by cashiers' check or money order 30 days prior to the beginning of my course unless other special arrangements are made with the school.

Terms:  All fees are in U.S. funds.  Our policy for deposits is that all monies paid are not refundable, and are considered as partial payment for the services of reserving time and space on the schedule and advance preparation of equipment and supplies.  We recommend that you obtain trip cancellation insurance to protect against any unforeseen circumstances that might cause cancellation.  Personal or company checks are acceptable for deposit, however payment of the balance of fees must be in guaranteed funds (cash, money order, cashiers' check, or travelers' check).
Assumption of Risks by Participant:  The activities that will be undertaken as a direct or indirect result of this reservation are commonly known to have various risks inherent to them.  By making this reservation, I agree that I knowingly and willingly accept those risks which are inherent in this activity or any associated activity.  I will not hold, nor attempt to hold, Scott Boulanger or the Western Montana School for Guides, or any of his agents or associates, responsible for loss, injury, or damages, as a direct or indirect result of my participation in those activities.
I, the undersigned, have read, fully understand, and agree to the above terms, conditions and assumption of risks as a condition of this application.

Signature: _____________________________________________________ Date of Signature: ______________________________


After completing this application, please mail to:  Western Montana School for Guides, c/o Scott Boulanger, PO Box 733, Darby, MT 59829
or call 1-406-821-0017 for fax information
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