Rocky Mountain Combat Applications Training
Until we have an online application form up and running on our new website, please Copy and past this form to MS Word or Notepad etc, then fill it out and paste it to an email and send it to peytonq1@gmail.com
Name (first) ___________________________(Last)_______________________
Height_______ Weight ______Age______ Today’s Date ___________
The date of the RMCAT class I am now applying to: _____________
Your email address: __________________________________
Street Address: ________________________ City ______________________
State _____ Zip _____________________
Cell Phone ( helps with airport pick up)_________________________
NOTE: All your answers are confidential and shared only with members of staff and even then only on a “need to know basis.” They only “need to know” when in my judgment (Peyton Quinn) it will allow them to better help you reach a specific goal you mentioned in this application.
Also on the back of this sheet or anywhere below if this is done real time in an email, please tell us anything about yourself or experience that you feel might help us to give you the best experience, training and personal goal centered outcome that we possibly can.
(1) Please identify and briefly explain your goals in attending this class and why you feel RMCAT training can allow you to achieve those goals:
(2) Have you ever been attacked, or “mugged” or robed at gunpoint or in any other way? If yes, briefly describe the event.
(3) Have you had any previous martial arts training? Yes ( ) No ( )
(4) Have you had any previous self-defense training? Yes ( ) No ( )
(5) Have you ever witnessed a real act of violence, in the street, a bar or elsewhere?
Yes ( ) No ( ) If yes then please explain the context:
(6) Do you have any felony convictions? If yes, then please explain below.
(7) Are you applying to take the scenario based firearms course ( which includes some stick and knife work) as well which is held Monday and Tuesday after the armored assailant class ends Sunday: Yes ( ) No ( ) ?
If yes, please explain what experiences you have with firearms and any firearms training you have had: (i.e Front Site, LFI, etc).
(8) How did you first hear about RMCAT Training: Please check all that apply:
( ) I found you on web search ( ) A friend took the course and highly recommended it ( ) I read about your program in a magazine article. ( ) If you saw us on a TV program please check which program here ( ) History Chanel ( ) The View ( ) Tactical to Practical ( ) Other TV program. ( ) I read Peyton’s book Freedom From Fear ( ) I read Peyton’s Book : Real Fighting: Adrenal stress Conditioning Through Scenario Based Training
About the release: In sending us this completed application you are agreeing to the terms of the release below. In this release you give up certain legal rights in order to participate in the course. A personal word on the course: I can say that we have not had any serious injury (broken bone, lost tooth, joint injury etc) in this course in well over a decade. A slight sprain or even a slight bruise sometimes occurs, but even that is not common really.
RELEASE Of Liability: I realize that self-defense training, and this course in particular, has some inherent risks of personal injury for me. I accept any and all of these risks in submitting this application and I release RMCAT and Rancho Grande Ent, LLC and all other attendants or instructors in this course, including Peyton Quinn, from any and all liability for any injury, be it physical or psychological, that I might suffer as result of this course.
Signed ____________________________________________DATE________________
You will be asked to sign this release before the training when you arrive here, but if you have an electronic signature please use it here.
Please Print your name here ____________________________
We will email you promptly on the status of your application and Thanks for intrest and understanding of RMCAT!