RIGSTAR Training Application
Please Type or Print Clearly ---------Instructions-------------------------------------------------------------------------------------Date___/___/___
Address___________________________________________City________________ State___________ Zip Code_____________ Country ___________________
Which course are you interested in attending: "The Complete Rigger" [ ] or "Right To The Point" [ ] or "Construction and Industrial Rigging" [ ] Custom Course [ ]
Any added days you are requesting to your course?: Yes [ ] No [ ] If yes how many: ________ Pricing on Any added days is $457.14 per 8 hour day (This adder is only for those wanting to extend beyond their 7 day course.)
[ ] Custom Class Course: Number of days________ Cost: $75 per Hour per student = Total __________
[ ] 7 Days "Complete Rigger" Hands on Training and Testing Certification course ($3,200.00)
Modules 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13
Please Note that Riggers Classification Level is issued based on each students hands on performance during the course.
[ ] 7 Days "Right To The Point" Hands on Training and Testing Certification course ($3,200.00)
[ ] 1 day Basic rigging seminar. ($750.00) no testing is involved.
[ ] Two day Seminar ($1,500.00) no testing is involved.
[ ] 4 weeks Hands on Training & Testing Tour Rigging Certification ($12,800.00) for a
[ ] 7 day Construction and Industrial Rigging Certification Course ($3,200.00)
Certification is based on the Testing Modules that a student has Passed.
Hands on testing will be based on closed book for Level 1 , 2 and 3.
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?_________________________
Do You have any form of Dyslexia? ____________ How sevear if yes? ______________________________ Do you take medication for it? ____________ Do you have any form of ADD? ____________
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_________________
Prerequisites to attend the Rigstar Training and Testing Center:
Be able to read, understand, comprehend and speak the English language fluently is a must in succeeding in our rigging course.
Should be able to read and understand all marks on a scaled ruler.
Should be able to change a fraction into a decimal number and understand the decimal number system.
Must be able to conduct basic math functions on a calculator such as Add, Subtract, Divide, and Multiply is a must.
Do you conform to all the above "Prerequisites" Yes______ No _______
Please list in detail the experience that you have in the following areas:
|Block and Falls_______________________||Electronics/Electricity__________________________________|
|Steel Cables_________________________||Maintenance/Repair of chain hoists_______________________|
|Shackles____________________________||Maintenance/Repair of control systems____________________|
|Hooks______________________________||Use of computerized control systems______________________|
|Oval Rings__________________________||Use of digital preset counters____________________________|
|Turn Buckles_________________________||Laser rigging techniques_______________________________|
|Round Slings________________________||Load and break testing_________________________________|
|K-Link Slings________________________||Fall protection_______________________________________|
|Carabiners___________________________||Correct use of rigging materials__________________________|
|Repelling Equipment___________________||Bending moments of materials___________________________|
|Motor Control Systems_________________||Side loading, compression______________________________|
|Hanging Lighting Systems______________||Hanging Speaker Systems______________________________|
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 throughout the course) Yes_________ No______
Full payment is due at least 21 days before attending to guarantee a seat. We suggest you reserve a spot at least 30 days or more in advance since space will be limited to only 6 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". "When a student starts the course, "No refund will be given once the class has started".
You will not suffer the loss 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.
Uncontrollable conditions: The Rigstar Training and Testing Center and any employee will not be held responsible for any condition that may delay training due to adverse weather or power outage beyound Rigstar's control.
All reasonable efforts will be taken by Rigstar Training and Testing Center to reschedule lost time in a class due to uncontrollable conditions as stated but will not be liable for any additional expenses that a student may incur.
Day Course Time Schedule may be altered in any given day: Please Note that the start times and end times may change during the course week due to prior commitments or other obligations that the instructor may have.
So if a class day ends earlier than normal then the start time the following day may start earlier or may go longer to make shure you receive all the time needed
to complete the full course training. There is always extra time allotted during the week days as well as the weekend to make up any behind time that may happen.
I understand the illegal drug and alcohol policy set forth below of the Rigstar Training Center and know that if I fail to comply to these guidelines I will be dismissed without reimbursement of any kind."
Illegal Drugs, Alcohol, Missed Days, and Misconduct Policy: No one will be allowed to attend any class under the influence of illegal drugs and or alcohol. Being hung over from going out in the evening prior to the next day class will be considered as under the influence and you will not be allowed to attend that day's class. You agree to leave the class when asked by any Rigstar instructor if you are under the influence of any illegal drugs and or alcohol. There will not be any make up days during your week class. You may make up any day lost for an additional fee after the completetion of your scheduled week. You must attend the scheduled number of days and hours for your week as part of your requirements to qualify for the Rigstar Certification. Any misconduct or inappropriate behavior of any kind during a class will be grounds for immediate dismissal from the class without reimbursement of any kind.
"I further understand and agree that I will not be allowed to arrive at the Rigstar Training course if sick with any form of the flu and I will contact Rigstar in advance of such sickness but will be allowed to reschedule to another class week." I also understand and agree that there will be no reimbursement of any kind due to my illness.
"I certify that the facts contained in this application are true and complete to the best of my knowledge and I agree to all conditions to the Rigstar Application.
WAIVER AND ASSUMPTION OF RISK
For The Rigstar Training and Testing Center Course
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___________________
Print this application and waver. Fill out completely and sign. Fax, Email or Postal Mail to:
Make payment payable to: Rigstar Training and Testing Center or RIGSTAR CORPORATION
(The RIGSTAR Training and Testing Center is a Div. of the RIGSTAR CORPORATION)
82 Industrial Drive Unit 4
Northampton, MA 01060
Any questions please do not hesitate in contacting Steven Kendall at 1(413) 585-9869 or email: firstname.lastname@example.org
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