2022 SRT Registration

Swiftwater Rescue Class Sign Up

Swiftwater Rescue Technician and Advanced class sign up
We offer a $25 discount per class if you pay more than 7 days before the first day of class through Venmo. Please send payment to @Matt-Adams-Crux by or bring a check or credit card for the correct amount on the first day of class.
Name: *

First Name Last Name
CERTs

CERT1 CERT2
Organization / Company
Please do not abbreviate.
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Email Address *
Home/ Mobile Phone Number *
Work Phone Number
Course Details

Instructor / Training Provider - Travis Reid
Course Type *
Class Location

Street Address Line 2

City State

Zip Code
Course Code
Other instructors
Emergency Contact
Name #1

First Name Last Name
Phone Number

Area Code Phone Number
Name #2

First Name Last Name
Phone Number

Area Code Phone Number
ID Card Image

If you would like an ID Card, please take or upload a Passport style head shot
Take a head shot
Upload a Head shot

Swiftwater Rescue Class Sign Up