HEAT Registration - Concilium Inc. - Christian Discipleship & Security Training

HEAT Registration

Please Note: If the minimum number of participants required to operate any course is not reached 45 days prior to a published class start date, the course will be rescheduled and you will be notified. You will then have the option of applying all fees to a rescheduled or different course option. If you choose not to re-schedule, all refundable fees will be returned to your account. Please wait for final course confirmation before scheduling travel.

Available Course: *

Check Calendar for next available date

Name *

First

Last

Phone *

Email *

Organization/Employer *

Website / URL

Staff Position or Organization Role *

Countries of Primary Operation *

Primary Emergency Contact Name *

First

Last

Primary Emergency Contact Email *

Primary Emergency Contact Phone *

Relationship *

Additional Emergency Contact (ie: Organizational Care, Healthcare, or Pastoral Care Contact, etc) *

First

Last

Additional Emergency Contact Relationship *

Additional Emergency Contact Number *

Additional Emergency Contact Email *

Medical conditions *

If none, type N/A

All Current Medications *

If none, type N/A

Please briefly describe any prior critical incident or trauma experiences *

If none, type N/A

List previous crisis management, security, law enforcement, or military training *

If none, type N/A

Comments, questions, or concerns

How did you hear about this course? *

Are you commuting to the course? *

HEART Course Cost (includes lodging and meals) *

Course Fee $1650 (includes a $300 non-refundable registration fee due with submission)

Payment remainder due 30 days prior to course start date.

Payment Amount *

Paying by credit or debit card? *

A minimum non-refundable $300 registration fee is required to reserve a course. Remaining course fee balance can be paid immediately or no later than 30 days prior to course start date. *

I Agree

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