Distance Education Individual Training Application

Personal Information

First Name

Last Name

Street Address

Address Line 2

City

State

State/Province outside USA

Country

Phone Number

Email Address

Personal Status

What Are You?

Active Duty Police

Active Duty Military

Active Duty Corrections/Security

Private Citizen no knowledge of combatives

Private Citizen / some knowledge of combatives

Private Citizen / intermediate knowledge of combatives

Private Citizen / advanced knowledge of combatives

Why Do You Wish to Join a Distance Course with Combative Options?

For personal advancement

I would like to become certified

What weapon (s) do you usually carry for work or personal protection?

Do you have a criminal record or are you currently under investigation by the authorities?

Yes

No

If you answered "Yes" to the question above, please explain your circumstances.

Available Courses

Please choose your course.

Distance Courses Available and Tuition Costs - All Courses in USD unless otherwise specified.

Group Leader Certification Course - Distance Education - $499.99

Languages Available

What language do you wish to learn in?

English

These are the same materials that we use in our training courses, you may buy them seperately if you wish.

Training Agreement

By signing this application, I understand and agree to the following:

1. Combative Options depends upon the respect of every student. I understand that my instruction may be terminated at any time if the instructor deems that my attitude is personal behavior is unsatisfactory.

2. I am not currently under indictment or prosecution for any offense. I am not wanted for questioning or arrest by any law enforcement or government agency. I have no history of mental illness, drug or alchohol abuse.

3. I will obey all safety procedures required as set forth by Combative Options Academy and its instructors. I am aware that the practice of combatives can be physically stressful or dangerous and in certain instances can even be harmful and result in injury or death. I voluntarily accept this risk and do not hold Combative Options Group or its instructors responsible for any injuries I might recieve resulting from training in their courses and programs.
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4. I will not use the knowledge I gain through Combative Options distance courses for any illegal or criminal purpose.

5. I will be at least 18 years of age at the time of class.

Do you agree to the above?

Yes, I do.

No, I do not.

Tuition Payment

Alertpay.com Payments

Course Tuition - 499.99 US Dollars - 550.00 Canadian Dollars

STEPS

1. Click Here to open a new ALERTPAY PAYMENT WINDOW

2. Complete a secure payment with alertpay.com

3. Return to this window and submit this registration form after payment.

Other Payment Methods

Western Union Money Transfer - Please email us for this option at sales@cogtactical.com

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