Please Type or Print Clearly ---------Instructions-------------------------------------------------------------------------------------Date___/___/___

Name______________________________________________________________

Company Name______________________________________________________

Address___________________________________________City________________ State___________ Zip Code_____________ Country ___________________

Phone ___________________________Fax______________________________

E-Mail address__________________________________________________

Which are you interested in:

Please check Schedule dates for dates offered for the current year

What dates would you be interested in attending the Training Center?_____________________________

To attend you must be 18 years or older for the hands on course or have parental permission.

Are you 18 years or older? [ ] Yes [ ] No --Date of birth___/___/____

Height ___ feet ___ inches --Weight____ pounds

Circle One: My health and physical condition is: -------------------------Excellent / Good / Fair / Poor

Have you had any injuries that may affect your ability to perform in the rigging industry? (Please List)

___________________________________________________________________________________

Are you on any medications that may effect your vision, balance, awareness, cause drowsiness, or affect your ability to astutely comprehend any part of the course?__________________________

Maximum weight you can safely lift?_________

Do you have any fears of heights?_________

You may be restricted to participate in only a portion of the course due to your health and physical condition. These restrictions may be determined by Rigstar if it is decided that your safety may be at risk or may cause a risk to the safety of other participants.

Education Background:--College___________________--Trade or Business School_____________________

Name and Location of School:_______________________________________

Years attended_______________Did you Graduate?_______ Subjects_______________________________

In case of emergency notify: Name_________________________________Relationship_____________________________

Address_______________________________________________ Phone Number_________________

Please list in detail the experience that you have in the following areas:

Please list any other related experience________________________________________________________

Have you attended other rigging seminars?_________Where__________________________________

Which aspects of the rigging industry would you like to expand your knowledge on while attending the Rigstar Training Center?

_____________________________________________________________________________________

_____________________________________________________________________________________

Upon completion of the course would you like to be tested on your knowledge and ability? (Please know that you may change your decision on this answer at anytime through the course)_________

A 50% deposit is required to hold your spot and the balance is due 21 days before attending. We suggest you reserve a spot at least 30 days or more in advance since space will be limited to only 8 students for each class. Refunds will be sent out if notified at least 14 days in advance, in writing by certified mail only, of their class date, less $50.00 for administration costs. Fax or e-mail will not be accepted as a notice of cancellation from a participant, due to possible electronic problems. "No refund will be given there after the 14 day notice policy".

You will not suffer the lost of the administration charge of $50.00 as long as you reschedule and your full payment has been made.
The $50.00 will be forfeited if you request your money back 14 days before the class starts.
If notice of cancelation is not given 14 days in advance prior to your schedule start date of the class,
you will forfeit the total amount, but you will have 2 months to reschedule a date within the next 2 months
after your 1st schedule date. I will try to accommodate each person in a matter like this as best as possible.

Please note that no one is confirmed a seat unless full payment is cleared in our bank at least two weeks before
their schedule starting date that they picked. Out of state checks take about 5 to 7 business days to clear so you
would have to allow an additional week within the process totaling 3 weeks before your starting date.
To speed up the process it would be best to Fed-X a Cashiers check or certified bank Money order.
This we know is guarantied funds by a bank. I am sorry to say but we do not take any form of credit cards
or Purchase Orders at this time. Please do not send any cash through the mail.

Any one from outside the United States will have to transfer funds via bank wire transfer direct to our account and must be
cleared 14 days before attending the starting date of the class they have picked along with any bank surcharges or fees that
may occur to our account because of the wire transfer.

If you are going to stay at one of the hotels listed on my web site, I would be more than happy to pick you up each
morning and bring you back to your hotel in the evening after class.

All attendees must be covered by their own medical insurance. Attendees of the Rigstar Training center will assume all risk of any injury that may happen to them while at the Rigstar Training Center and on any field trips.

The Rigstar Training and Testing Center does not guarantee an attendee of this class is suited or knowledgeable enough for any specific job that he or she may apply for after attending the Rigstar Training and Testing Center due to each persons own learning capabilities.

"I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand the illegal drug and alcohol policy of the Rigstar Training Center and know that if I fail to comply to these guidelines I will be dismissed without reimbursement for tuition fees."

Date_______________Signature___________________________________________________________

The undersigned,___________________________ (Trainee), voluntarily makes and grants this Waiver and Assumption of Risk in favor of The Rigstar Training and Testing Center as partial consideration (in addition to monies paid to Rigstar; and/or to receive assistance, training, guidance, tutelage and/or instruction from the personnel of Rigstar; and/or to engage in the activities, events, sports, festivities and/or gatherings sponsored by Rigstar.

I,_____________________________do hereby waive and release any and all claims whether in contract or of personal injury, bodily injury, property damage, damages, losses and/or death that may arise from my participation in the Rigstar Training and Testing Course, as I understand and recognize that there are certain risks, dangers, and perils connected with such course, which I hereby acknowledge have been fully explained to me and which I fully understand, and which I nevertheless accept, assume and undertake after inquiry and investigation of extent, duration, and completeness wholly satisfactory and acceptable to me. I further agree to use my best judgement in undertaking these activities, and to faithfully adhere to all instructions, safety or otherwise, and recommendations, whether oral or written. I hereby certify that I am a competent adult assuming these risks of my own free will being under no compulsion or duress. This Waiver and Assumption of Risk is effective from_______(year), to_______(year), inclusive, and may not be revoked, altered, amended, rescinded or voided without the express prior written consent of Rigstar. Also by signing this form, you are giving permission to the Rigstar Training and Testing Center
and any associated member of our company to take pictures and or videos of you in a class at any time to be used for possible training and or promotional advertisement of the company in any way it feels fit for a one time fee of no more than $1.00 dollar if any such video or pictures of you are to be used.
The Rigstar Training and Testing Center will be the sole owner of any and all videos and or pictures taken during the class dates.

Print Name______________________________________ Date__________________

Trainee's Signature________________________________. Age___________________

Address.__________________________________________________________________

_________________________________________________________________________

-

-

Instructions:

Print this application and waver. Fill out completely and sign. Fax or mail to:

RIGSTAR

82 Industrial Drive Unit 4

Northampton, MA 01060

Fax: 413-585-9872