{"id":14487,"date":"2019-12-09T10:55:40","date_gmt":"2019-12-09T18:55:40","guid":{"rendered":"https:\/\/pelicorp.com\/pfctrainingdev.com\/?page_id=14487"},"modified":"2019-12-10T05:53:41","modified_gmt":"2019-12-10T13:53:41","slug":"star-release-form","status":"publish","type":"page","link":"https:\/\/pelicorp.com\/pfctrainingdev.com\/star-release-form\/","title":{"rendered":"Student Information and Release of Liability"},"content":{"rendered":"<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-14245\"><form id=\"wpforms-form-14245\" class=\"wpforms-validate wpforms-form\" data-formid=\"14245\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/pfctrainingdev.com\/wp-json\/wp\/v2\/pages\/14487\" data-token=\"1ba8a5ca62848e8e09ec7833f2ebd1b9\" data-token-time=\"1780455880\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-14245-field_14-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"14\"><h3 id=\"wpforms-14245-field_14\">STUDENT TRAINING ATTENDANCE RECORD <\/h3><\/div><div id=\"wpforms-14245-field_1-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"1\"><label class=\"wpforms-field-label\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-14245-field_1\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][1][first]\" required><label for=\"wpforms-14245-field_1\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-14245-field_1-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][1][last]\" required><label for=\"wpforms-14245-field_1-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-14245-field_43-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"43\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_43\">Address <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-14245-field_43\" class=\"wpforms-field-address-address1 wpforms-field-required\" name=\"wpforms[fields][43][address1]\" placeholder=\"Address\" required><label for=\"wpforms-14245-field_43\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-14245-field_43-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][43][address2]\" placeholder=\"Suite, Apt, etc\" ><label for=\"wpforms-14245-field_43-address2\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-14245-field_43-city\" class=\"wpforms-field-address-city wpforms-field-required\" name=\"wpforms[fields][43][city]\" placeholder=\"City\" required><label for=\"wpforms-14245-field_43-city\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-14245-field_43-state\" class=\"wpforms-field-address-state wpforms-field-required\" name=\"wpforms[fields][43][state]\" required><option class=\"placeholder\" value=\"\" selected disabled>--- Select state ---<\/option><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >District of Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawaii<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Louisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >Michigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Mississippi<\/option><option value=\"MO\" >Missouri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >New Hampshire<\/option><option value=\"NJ\" >New Jersey<\/option><option value=\"NM\" >New Mexico<\/option><option value=\"NY\" >New York<\/option><option value=\"NC\" >North Carolina<\/option><option value=\"ND\" >North Dakota<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oregon<\/option><option value=\"PA\" >Pennsylvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >South Carolina<\/option><option value=\"SD\" >South Dakota<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >West Virginia<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-14245-field_43-state\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">State<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-14245-field_43-postal\" class=\"wpforms-field-address-postal wpforms-field-required wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][43][postal]\" placeholder=\"Zip Code\" required><label for=\"wpforms-14245-field_43-postal\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Zip Code<\/label><\/div><\/div><\/div><div id=\"wpforms-14245-field_49-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"49\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_49\">Phone<\/label><input type=\"tel\" id=\"wpforms-14245-field_49\" class=\"wpforms-field-medium wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][49]\" aria-label=\"Phone\" ><\/div><div id=\"wpforms-14245-field_3-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_3\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-14245-field_3\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][3]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-14245-field_7-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_7\">Date of Birth <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-14245-field_7\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][7]\" required><\/div><div id=\"wpforms-14245-field_11-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_11\">Occupation \/ Employer <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-14245-field_11\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][11]\" required><\/div><div id=\"wpforms-14245-field_12-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_12\">Emergency Contact: Name and Phone Number <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-14245-field_12\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][12]\" required><\/div><div id=\"wpforms-14245-field_17-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_17\">How did you hear about PFC? <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-14245-field_17\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][17]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Please choose<\/option><option value=\"Previous Client\"  class=\"choice-1 depth-1\"  >Previous Client<\/option><option value=\"Employer\"  class=\"choice-2 depth-1\"  >Employer<\/option><option value=\"Google\"  class=\"choice-3 depth-1\"  >Google<\/option><option value=\"Facebook\"  class=\"choice-6 depth-1\"  >Facebook<\/option><option value=\"Instagram\"  class=\"choice-5 depth-1\"  >Instagram<\/option><option value=\"Friend\"  class=\"choice-4 depth-1\"  >Friend<\/option><\/select><\/div><div id=\"wpforms-14245-field_18-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_18\">May we use photos, video, or written comments taken during this training or event in future promotional efforts? <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-14245-field_18\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][18]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Please choose<\/option><option value=\"Yes, you may use Photos AND Written Comments\"  class=\"choice-1 depth-1\"  >Yes, you may use Photos AND Written Comments<\/option><option value=\"Yes, you may use Written Comments only\"  class=\"choice-5 depth-1\"  >Yes, you may use Written Comments only<\/option><option value=\"Yes, you may use Photos only\"  class=\"choice-3 depth-1\"  >Yes, you may use Photos only<\/option><option value=\"No, you may not use either\"  class=\"choice-2 depth-1\"  >No, you may not use either<\/option><\/select><\/div><div id=\"wpforms-14245-field_19-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"19\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_19\">I registered for this training or event via:<\/label><select id=\"wpforms-14245-field_19\" class=\"wpforms-field-medium\" name=\"wpforms[fields][19]\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Please choose<\/option><option value=\"Website\"  class=\"choice-1 depth-1\"  >Website<\/option><option value=\"Phone\"  class=\"choice-2 depth-1\"  >Phone<\/option><option value=\"Email\"  class=\"choice-3 depth-1\"  >Email<\/option><option value=\"In-Person\"  class=\"choice-6 depth-1\"  >In-Person<\/option><option value=\"Unit\/Company Rep\"  class=\"choice-5 depth-1\"  >Unit\/Company Rep<\/option><option value=\"Other\"  class=\"choice-4 depth-1\"  >Other<\/option><\/select><\/div><div id=\"wpforms-14245-field_20-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_20\">Payment Method<\/label><select id=\"wpforms-14245-field_20\" class=\"wpforms-field-medium\" name=\"wpforms[fields][20]\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Please choose<\/option><option value=\"Credit Card\"  class=\"choice-1 depth-1\"  >Credit Card<\/option><option value=\"Personal Check\"  class=\"choice-2 depth-1\"  >Personal Check<\/option><option value=\"Government Funding\"  class=\"choice-3 depth-1\"  >Government Funding<\/option><option value=\"Invoice My Employer\"  class=\"choice-6 depth-1\"  >Invoice My Employer<\/option><option value=\"Cash\"  class=\"choice-5 depth-1\"  >Cash<\/option><option value=\"N\/A\"  class=\"choice-4 depth-1\"  >N\/A<\/option><\/select><\/div><div id=\"wpforms-14245-field_21-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_21\">Payment Status<\/label><select id=\"wpforms-14245-field_21\" class=\"wpforms-field-medium\" name=\"wpforms[fields][21]\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Please choose<\/option><option value=\"Paid In-Full\"  class=\"choice-1 depth-1\"  >Paid In-Full<\/option><option value=\"Partially Paid\"  class=\"choice-2 depth-1\"  >Partially Paid<\/option><option value=\"Pending\"  class=\"choice-3 depth-1\"  >Pending<\/option><option value=\"Comped\"  class=\"choice-6 depth-1\"  >Comped<\/option><option value=\"Work Credit\"  class=\"choice-5 depth-1\"  >Work Credit<\/option><option value=\"Unknown\"  class=\"choice-4 depth-1\"  >Unknown<\/option><\/select><\/div><div id=\"wpforms-14245-field_40-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"40\"><\/div><div id=\"wpforms-14245-field_41-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"41\"><\/div><div id=\"wpforms-14245-field_13-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"13\"><h3 id=\"wpforms-14245-field_13\">RELEASE OF LIABILITY AND ASSUMPTION OF THE RISK<\/h3><\/div><div id=\"wpforms-14245-field_10-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_10\">Course \/ Event Date <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-14245-field_10\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-required wpforms-field-small\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][10][date]\" required><a title=\"Clear Date\" data-clear role=\"button\" tabindex=\"0\" class=\"wpforms-datepicker-clear\" aria-label=\"Clear Date\" style=\"display:none;\"><\/a><\/div><\/div><div id=\"wpforms-14245-field_9-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_9\">Name of Course \/ Event <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-14245-field_9\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][9]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Please Choose Course\/Event<\/option><option value=\"Media Event\"  class=\"choice-131 depth-1\"  >Media Event<\/option><option value=\"Specialty \/ Other\"  class=\"choice-115 depth-1\"  >Specialty \/ Other<\/option><option value=\"Academy of Protective Studies (APS)\"  class=\"choice-143 depth-1\"  >Academy of Protective Studies (APS)<\/option><option value=\"Active Violence Event Response Tactics (AVERT)\"  class=\"choice-1 depth-1\"  >Active Violence Event Response Tactics (AVERT)<\/option><option value=\"Active Violence Event Response Tactics Instructor Certification (AVERT-IC)\"  class=\"choice-2 depth-1\"  >Active Violence Event Response Tactics Instructor Certification (AVERT-IC)<\/option><option value=\"Advanced Patrol Rifle (APR)\"  class=\"choice-144 depth-1\"  >Advanced Patrol Rifle (APR)<\/option><option value=\"Advanced Protective Pistol Skills (APPS)\"  class=\"choice-3 depth-1\"  >Advanced Protective Pistol Skills (APPS)<\/option><option value=\"Advanced Protective Security Operations Certification (APSOC)\"  class=\"choice-4 depth-1\"  >Advanced Protective Security Operations Certification (APSOC)<\/option><option value=\"Armed Physical Defense (APD)\"  class=\"choice-57 depth-1\"  >Armed Physical Defense (APD)<\/option><option value=\"C4C Two-Day Workshop \"  class=\"choice-147 depth-1\"  >C4C Two-Day Workshop<\/option><option value=\"C4C Police Jiu-Jitsu Level 1 (C4CPJJ1)\"  class=\"choice-139 depth-1\"  >C4C Police Jiu-Jitsu Level 1 (C4CPJJ1)<\/option><option value=\"C4CPJJ Weapon Retention &amp; Defense Fundamentals (WRDF)\"  class=\"choice-137 depth-1\"  >C4CPJJ Weapon Retention &amp; Defense Fundamentals (WRDF)<\/option><option value=\"Code 4 Concepts; Control Tacticts (C4C-CT)\"  class=\"choice-56 depth-1\"  >Code 4 Concepts; Control Tacticts (C4C-CT)<\/option><option value=\"Code 4 Concepts; Defense Tactics (C4C-DT)\"  class=\"choice-55 depth-1\"  >Code 4 Concepts; Defense Tactics (C4C-DT)<\/option><option value=\"Code 4 Concepts; Control &amp; Defense Seminar\"  class=\"choice-138 depth-1\"  >Code 4 Concepts; Control &amp; Defense Seminar<\/option><option value=\"Code 4 Concepts; Edge Weapon Defense (C4C-EWD)\"  class=\"choice-54 depth-1\"  >Code 4 Concepts; Edge Weapon Defense (C4C-EWD)<\/option><option value=\"Code 4 Concepts; Office &amp; Public Safety (C4C-OPS)\"  class=\"choice-53 depth-1\"  >Code 4 Concepts; Office &amp; Public Safety (C4C-OPS)<\/option><option value=\"Code 4 Tactics (C4T)\"  class=\"choice-52 depth-1\"  >Code 4 Tactics (C4T)<\/option><option value=\"Code 4 Tactics Instructor Certification (C4T-IC)\"  class=\"choice-51 depth-1\"  >Code 4 Tactics Instructor Certification (C4T-IC)<\/option><option value=\"C4C Workshop - Combatives for Weapon Retention &amp; Defense\"  class=\"choice-133 depth-1\"  >C4C Workshop - Combatives for Weapon Retention &amp; Defense<\/option><option value=\"Combative Concealed Handgun (CCH)\"  class=\"choice-50 depth-1\"  >Combative Concealed Handgun (CCH)<\/option><option value=\"Concealed Handgun 1 (CH1); Fighting foundation\"  class=\"choice-118 depth-1\"  >Concealed Handgun 1 (CH1); Fighting foundation<\/option><option value=\"Concealed Handgun 2 (CH2); Fighting Positions\"  class=\"choice-122 depth-1\"  >Concealed Handgun 2 (CH2); Fighting Positions<\/option><option value=\"Concealed Handgun 3 (CH3); Movement Under Fire\"  class=\"choice-121 depth-1\"  >Concealed Handgun 3 (CH3); Movement Under Fire<\/option><option value=\"Covert Operations &amp; Protective Surveillance (COPS)\"  class=\"choice-49 depth-1\"  >Covert Operations &amp; Protective Surveillance (COPS)<\/option><option value=\"Countering Active Violence Events (CAVE)\"  class=\"choice-58 depth-1\"  >Countering Active Violence Events (CAVE)<\/option><option value=\"Custom Combatives And Tactics (CCAT)\"  class=\"choice-69 depth-1\"  >Custom Combatives And Tactics (CCAT)<\/option><option value=\"Custom Firearms And Tactics (CFAT)\"  class=\"choice-68 depth-1\"  >Custom Firearms And Tactics (CFAT)<\/option><option value=\"Custom Protection And Tactics (CPAT)\"  class=\"choice-67 depth-1\"  >Custom Protection And Tactics (CPAT)<\/option><option value=\"Custom Driving Program (CDP)\"  class=\"choice-66 depth-1\"  >Custom Driving Program (CDP)<\/option><option value=\"Deploying Unit Skills &amp; Tactics (DUST)\"  class=\"choice-65 depth-1\"  >Deploying Unit Skills &amp; Tactics (DUST)<\/option><option value=\"Firearms Training And Qualification (FTAQ)\"  class=\"choice-64 depth-1\"  >Firearms Training And Qualification (FTAQ)<\/option><option value=\"Full Spectrum Operators Certification (FSOC)\"  class=\"choice-63 depth-1\"  >Full Spectrum Operators Certification (FSOC)<\/option><option value=\"Full Spectrum Operator Course - Expanded (FSOC-X)\"  class=\"choice-62 depth-1\"  >Full Spectrum Operator Course - Expanded (FSOC-X)<\/option><option value=\"Fundamental Carbine Skills (FCS)\"  class=\"choice-126 depth-1\"  >Fundamental Carbine Skills (FCS)<\/option><option value=\"Fundamental Handgun Skills (FHS)\"  class=\"choice-124 depth-1\"  >Fundamental Handgun Skills (FHS)<\/option><option value=\"Fundamental Shotgun Skills (FSS)\"  class=\"choice-125 depth-1\"  >Fundamental Shotgun Skills (FSS)<\/option><option value=\"Handgun Optics Skills &amp; Tactics (HOST)\"  class=\"choice-135 depth-1\"  >Handgun Optics Skills &amp; Tactics (HOST)<\/option><option value=\"High Angle \/ Low Angle Patrol Rifle (HLPR)\"  class=\"choice-145 depth-1\"  >High Angle \/ Low Angle Patrol Rifle (HLPR)<\/option><option value=\"High Threat Security Operations Certification (HTSOC)\"  class=\"choice-61 depth-1\"  >High Threat Security Operations Certification (HTSOC)<\/option><option value=\"High Speed Marksmanship 1 (HSM-1)\"  class=\"choice-60 depth-1\"  >High Speed Marksmanship 1 (HSM-1)<\/option><option value=\"High Speed Marksmanship 2 (HSM-2)\"  class=\"choice-59 depth-1\"  >High Speed Marksmanship 2 (HSM-2)<\/option><option value=\"Handgun Optic Instructor Skills &amp; Tactics Certification (HOIST-C)\"  class=\"choice-142 depth-1\"  >Handgun Optic Instructor Skills &amp; Tactics Certification (HOIST-C)<\/option><option value=\"Home Invasion Defense &amp; Education 1 (HIDE-1)\"  class=\"choice-77 depth-1\"  >Home Invasion Defense &amp; Education 1 (HIDE-1)<\/option><option value=\"Home Invasion Defense &amp; Education 2 (HIDE-2)\"  class=\"choice-76 depth-1\"  >Home Invasion Defense &amp; Education 2 (HIDE-2)<\/option><option value=\"Intermediate Protective Pistol Skills (IPPS)\"  class=\"choice-75 depth-1\"  >Intermediate Protective Pistol Skills (IPPS)<\/option><option value=\"MiTRP\"  class=\"choice-129 depth-1\"  >MiTRP<\/option><option value=\"Modern Structure Clearing Strategies (MSCS)\"  class=\"choice-146 depth-1\"  >Modern Structure Clearing Strategies (MSCS)<\/option><option value=\"Nevada Conceal Carry (NV CCW)\"  class=\"choice-74 depth-1\"  >Nevada Conceal Carry (NV CCW)<\/option><option value=\"Precision Rifle Operator (PRO)\"  class=\"choice-140 depth-1\"  >Precision Rifle Operator (PRO)<\/option><option value=\"Pre-Hospitalization Trauma Life Support (PHTLS)\"  class=\"choice-73 depth-1\"  >Pre-Hospitalization Trauma Life Support (PHTLS)<\/option><option value=\"Progressive Handgun 1 (PH1); Fighting Foundation\"  class=\"choice-72 depth-1\"  >Progressive Handgun 1 (PH1); Fighting Foundation<\/option><option value=\"Progressive Handgun 2 (PH2); Fighting Positions\"  class=\"choice-71 depth-1\"  >Progressive Handgun 2 (PH2); Fighting Positions<\/option><option value=\"Progressive Handgun 3 (PH3); Movement Under Fire\"  class=\"choice-70 depth-1\"  >Progressive Handgun 3 (PH3); Movement Under Fire<\/option><option value=\"Progressive Handgun 4 (PH4); Low-Light Engagement\"  class=\"choice-87 depth-1\"  >Progressive Handgun 4 (PH4); Low-Light Engagement<\/option><option value=\"Progressive Handgun 5 (PH5); Extreme Engagement\"  class=\"choice-86 depth-1\"  >Progressive Handgun 5 (PH5); Extreme Engagement<\/option><option value=\"Progressive Handgun 1-5 Series\"  class=\"choice-85 depth-1\"  >Progressive Handgun 1-5 Series<\/option><option value=\"Progressive Carbine 1 (PC1); Fighting Foundation\"  class=\"choice-84 depth-1\"  >Progressive Carbine 1 (PC1); Fighting Foundation<\/option><option value=\"Progressive Carbine 2 (PC2); Fighting Positions\"  class=\"choice-83 depth-1\"  >Progressive Carbine 2 (PC2); Fighting Positions<\/option><option value=\"Progressive Carbine 3 (PC3); Movement Under Fire\"  class=\"choice-82 depth-1\"  >Progressive Carbine 3 (PC3); Movement Under Fire<\/option><option value=\"Progressive Carbine 4 (PC4); Low-Light Engagement\"  class=\"choice-81 depth-1\"  >Progressive Carbine 4 (PC4); Low-Light Engagement<\/option><option value=\"Progressive Carbine 5 (PC5); Extreme Engagement\"  class=\"choice-80 depth-1\"  >Progressive Carbine 5 (PC5); Extreme Engagement<\/option><option value=\"Progressive Carbine 1-5 Series\"  class=\"choice-79 depth-1\"  >Progressive Carbine 1-5 Series<\/option><option value=\"Progressive Firearms Skills (PFS)\"  class=\"choice-127 depth-1\"  >Progressive Firearms Skills (PFS)<\/option><option value=\"Progressive Shotgun 1 (PS1); Fighting Foundation\"  class=\"choice-78 depth-1\"  >Progressive Shotgun 1 (PS1); Fighting Foundation<\/option><option value=\"Progressive Shotgun 2 (PS2); Fighting Positions\"  class=\"choice-95 depth-1\"  >Progressive Shotgun 2 (PS2); Fighting Positions<\/option><option value=\"Progressive Shotgun 3 (PS3); Movement Under Fire\"  class=\"choice-94 depth-1\"  >Progressive Shotgun 3 (PS3); Movement Under Fire<\/option><option value=\"Progressive Shotgun 4 (PS4); Low-Light Engagement\"  class=\"choice-93 depth-1\"  >Progressive Shotgun 4 (PS4); Low-Light Engagement<\/option><option value=\"Progressive Shotgun 5 (PS5); Extreme Engagement\"  class=\"choice-92 depth-1\"  >Progressive Shotgun 5 (PS5); Extreme Engagement<\/option><option value=\"Progressive Shotgun 1-5 Series\"  class=\"choice-91 depth-1\"  >Progressive Shotgun 1-5 Series<\/option><option value=\"Protective Security Operations Certification (PSOC) - PADS and PPS (5 day course)\"  class=\"choice-90 depth-1\"  >Protective Security Operations Certification (PSOC) - PADS and PPS (5 day course)<\/option><option value=\"Protective Security Operations Certification (PSOC) - PADS only (4 day course)\"  class=\"choice-89 depth-1\"  >Protective Security Operations Certification (PSOC) - PADS only (4 day course)<\/option><option value=\"Protective Pistol Skills (PPS)\"  class=\"choice-88 depth-1\"  >Protective Pistol Skills (PPS)<\/option><option value=\"Protective Physical Defense (PPD)\"  class=\"choice-134 depth-1\"  >Protective Physical Defense (PPD)<\/option><option value=\"Protective Driving Operations Course (PDOC)\"  class=\"choice-98 depth-1\"  >Protective Driving Operations Course (PDOC)<\/option><option value=\"Protective Driving Operations Course Recertification (PDOC-R)\"  class=\"choice-97 depth-1\"  >Protective Driving Operations Course Recertification (PDOC-R)<\/option><option value=\"Protective Operations Supervisor Training (POST)\"  class=\"choice-96 depth-1\"  >Protective Operations Supervisor Training (POST)<\/option><option value=\"Progressive Fixed Blade (PFB)\"  class=\"choice-102 depth-1\"  >Progressive Fixed Blade (PFB)<\/option><option value=\"Progressive Folding Knife (PFK)\"  class=\"choice-101 depth-1\"  >Progressive Folding Knife (PFK)<\/option><option value=\"Red Dot Handgun (RDH)\"  class=\"choice-132 depth-1\"  >Red Dot Handgun (RDH)<\/option><option value=\"Residential Security Operations Certification (RSOC)\"  class=\"choice-130 depth-1\"  >Residential Security Operations Certification (RSOC)<\/option><option value=\"Security Officer Firearms Initial Certification (SOFIC)\"  class=\"choice-117 depth-1\"  >Security Officer Firearms Initial Certification (SOFIC)<\/option><option value=\"Small Gun Skills (SGS)\"  class=\"choice-99 depth-1\"  >Small Gun Skills (SGS)<\/option><option value=\"Solo Home Defense (SHD)\"  class=\"choice-136 depth-1\"  >Solo Home Defense (SHD)<\/option><option value=\"Surviving Active Violence Events (SAVE)\"  class=\"choice-100 depth-1\"  >Surviving Active Violence Events (SAVE)<\/option><option value=\"Tactical Precision Rifle Operator (TPRO)\"  class=\"choice-141 depth-1\"  >Tactical Precision Rifle Operator (TPRO)<\/option><option value=\"Threat Awareness &amp; Response (TAR)\"  class=\"choice-106 depth-1\"  >Threat Awareness &amp; Response (TAR)<\/option><option value=\"Trauma Immediate Response (TIR)\"  class=\"choice-109 depth-1\"  >Trauma Immediate Response (TIR)<\/option><option value=\"Trauma Care And Immediate Response (TCAIR)\"  class=\"choice-128 depth-1\"  >Trauma Care And Immediate Response (TCAIR)<\/option><option value=\"Trauma Care And Immediate Response Executive Protection (TCAIR-EP)\"  class=\"choice-105 depth-1\"  >Trauma Care And Immediate Response Executive Protection (TCAIR-EP)<\/option><option value=\"Trauma Care And Immediate Response for Military (TCAIR-MIL)\"  class=\"choice-104 depth-1\"  >Trauma Care And Immediate Response for Military (TCAIR-MIL)<\/option><option value=\"Trauma Care And Immediate Response Expanded (TCAIR-X)\"  class=\"choice-103 depth-1\"  >Trauma Care And Immediate Response Expanded (TCAIR-X)<\/option><option value=\"Tactical Firearms Instructor Certification (TFIC)\"  class=\"choice-108 depth-1\"  >Tactical Firearms Instructor Certification (TFIC)<\/option><option value=\"Tactical Firearms Instructor Certification - Simulation Training (TFIC-ST)\"  class=\"choice-107 depth-1\"  >Tactical Firearms Instructor Certification - Simulation Training (TFIC-ST)<\/option><option value=\"Tactical Firearms Instructor Certification - Carbine (TFIC-C)\"  class=\"choice-114 depth-1\"  >Tactical Firearms Instructor Certification - Carbine (TFIC-C)<\/option><option value=\"Tactical Firearms Instructor Certification - Handgun (TFIC-H)\"  class=\"choice-113 depth-1\"  >Tactical Firearms Instructor Certification - Handgun (TFIC-H)<\/option><option value=\"Tactical Driving Operations Course (TDOC)\"  class=\"choice-112 depth-1\"  >Tactical Driving Operations Course (TDOC)<\/option><option value=\"Tactical Driving Operations Course Recertification (TDOC-R)\"  class=\"choice-111 depth-1\"  >Tactical Driving Operations Course Recertification (TDOC-R)<\/option><\/select><\/div><div id=\"wpforms-14245-field_24-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"24\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_24\">I understand that I am participating in organized small arms, concealed carry, close-quarter combat\/physical defense, specialized training and\/or tactical training event or course of instruction (Course), using the training facilities for an event, and\/or participating as a spectator. Participation and\/or observation of such a Course or event exposes me to potential major and minor injuries including, but not limited to, gunshot wounds, blunt force trauma, lacerations, soft tissue injuries, injuries caused by back-splatter from steel targets, broken bones, concussions, etc. <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-14245-field_24\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][24]\" required><div class=\"wpforms-field-description\">Initials<\/div><\/div><div id=\"wpforms-14245-field_26-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"26\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_26\">I am participating in this Course on my own free will and FULLY UNDERSTAND AND ACCEPT the inherent risks associated with this training I choose to be involved in; and as a result, I, my family and heirs WILL HOLD HARMLESS AND FOREVER RELEASE the training facility, training facility owner, Progressive F.O.R.C.E. Concepts, L.L.C. training organization (the Training Organization), and Training Organization Instructor(s), including but not limited to Stephen J. Krystek, owners, associates, affiliates, immediate family, extended family and heirs from any liability whether intentional or unintentional acts or actions, injuries or death to my person, injuries or death to another person, or damage to property resulting from my participation in training and firing range use. <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-14245-field_26\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][26]\" required><div class=\"wpforms-field-description\">Initials<\/div><\/div><div id=\"wpforms-14245-field_27-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"27\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_27\">If I must use a Blackhawk Serpa holster or any holster that utilizes a trigger finger actuated retention mechanism, I do so of my own free will, fully recognizing and accepting the risks and hazards associated with this equipment. Furthermore, I WILL NOT make any legal claims of damage or losses resulting from injuries sustained during this or any other training or special event conducted by Progressive F.O.R.C.E. Concepts, LLC, or initiate any legal action of any kind against Progressive F.O.R.C.E. Concepts, LLC now or in the future. <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-14245-field_27\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][27]\" required><div class=\"wpforms-field-description\">Initials<\/div><\/div><div id=\"wpforms-14245-field_28-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_28\"> I understand the local environmental conditions are unforgiving, and further, hydration is my responsibility. Breaks to consume water have been provided by the Facility, Training Organization, and or Instructors. Furthermore, I, my family and heirs WILL HOLD HARMLESS AND FOREVER RELEASE the training facility, training facility owner, the Training Organization (Progressive F.O.R.C.E. Concepts, LLC), and Training Organization Instructor(s), including but not limited to Stephen J. Krystek, owners, associates, affiliates, immediate family, extended family and heirs from any liability resulting from my future actions as a result of the training obtained during this course. <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-14245-field_28\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][28]\" required><div class=\"wpforms-field-description\">Initials<\/div><\/div><div id=\"wpforms-14245-field_56-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"56\"><div id=\"wpforms-14245-field_56\"><b>The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is reported to be extremely contagious. The State of medical knowledge is evolving, but the virus is believed to spread from person-to-person contact and or by contact with contaminated surfaces and objects, and even possibly in the air. People reportedly can be infected and show no symptoms and therefore spread the disease. The exact methods of spread and contraction are unknown, and there is no known treatment, cure, or vaccine for COVID-19. Evidence has shown that COVID-19 can cause severe and potentially life-threatening illness and even death.<\/b><\/div><\/div><div id=\"wpforms-14245-field_57-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"57\"><div id=\"wpforms-14245-field_57\"><b>Progressive F.O.R.C.E. Concepts, L.L.C. cannot prevent you from becoming exposed to, contracting, or spreading COVID-19 while utilizing Progressive F.O.R.C.E. Concepts, L.L.C. services or premises. While P.F.C. has taken multiple steps to prevent the spread of COVID-19 within its facilities, it is not possible to prevent against the presence of the disease. Therefore, if you choose to utilize Progressive F.O.R.C.E. Concepts, L.L.C. services, and or enter onto Progressive F.O.R.C.E. Concepts, L.L.C. premises, you accept any residual risk of exposure to and\/or increasing your risk of contracting or spreading COVID-19.<\/b><\/div><\/div><div id=\"wpforms-14245-field_58-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"58\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_58\">ASSUMPTION OF RISK: I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 for myself in order to utilize Progressive F.O.R.C.E. Concepts, L.L.C. services, and enter Progressive F.O.R.C.E. Concepts, L.L.C. premises. These services are of such value to me that I accept the risk of being exposed to, contracting, and or spreading COVID-19 in order to utilize Progressive F.O.R.C.E. Concepts, L.L.C. services and premises in person [Rather than arranging for an alternative method of enjoying the same services virtually (e.g., videoconference).] <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-14245-field_58\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][58]\" required><\/div><div id=\"wpforms-14245-field_30-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"30\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_30\">I have no preexisting medical conditions that prevent me from attending and participating in this training course or event. <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-14245-field_30\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][30]\" required><div class=\"wpforms-field-description\">Initials<\/div><\/div><div id=\"wpforms-14245-field_29-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"29\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_29\"> By my signature on this document, I state that I have no criminal history preventing me from possessing a firearm and am not wanted for questioning or arrest by any law enforcement or government agency. I further state that I have no history of mental illness or substance abuse, and that I am not currently under, nor will I be under, the influence of alcohol or other controlled substance while participating in this training or special event. I understand that my participation in a training course or event may be terminated at any time if my actions are not deemed safe or appropriate by the training staff. I agree to follow and abide by ALL safety rules and procedures outlined by the training staff and will immediately report any sustained injuries. <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-14245-field_29\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][29]\" required><div class=\"wpforms-field-description\">Initials<\/div><\/div><div id=\"wpforms-14245-field_33-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"33\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_33\">I can provide one or more of the following on the first day of the training course or event if required: Picture ID \/ CCW \/ Background Check Documentation \/ Other Training Qualification Identification <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-14245-field_33\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][33]\" required><div class=\"wpforms-field-description\">Initials<\/div><\/div><div id=\"wpforms-14245-field_32-container\" class=\"wpforms-field wpforms-field-signature\" data-field-id=\"32\"><label class=\"wpforms-field-label\" for=\"wpforms-14245-field_32\"> I fully understand this document I have read, agree to abide by all of the above conditions, and understand this document is valid for and applies to the duration of the above-entitled training course of instruction or special event from the beginning date to the end date: <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-14245-field_32\" class=\"wpforms-signature-input wpforms-screen-reader-element wpforms-field-required\" data-is-wrapped-field=\"1\" name=\"wpforms[fields][32]\" autocomplete=\"off\" inputmode=\"none\" required><div class=\"wpforms-signature-wrap wpforms-field-row wpforms-field-large\"><canvas class=\"wpforms-signature-canvas\" id=\"wpforms-14245-field_32-signature\" 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