Registration Form To sign up for any class, Please send a $50 deposit for each class, Along with this form, to: PPE, LLC PO Box 81 Basin, Mt. 59631
Title Of Classes:
Registration Code (s) of Class Attending:
Date (s) of Class Attending:
Will you be staying in camp? (not required for 1 day class)
Yes _____ No ______
Do you need Personal Protective Equipment? (PPE)
Yes _____ No ______
If yes: Shirt Size: S___ M___ L___ XL__ XXL__ Pant Size: Waist:_________ Length:_________ Glove Size: S___ M___ L___
Special Dietary/Medical Information: ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________
Name: __________________________________________________ __________________________________________________	Your Phone # _________________________________________
Address: _________________________________________________ _________________________________________	Emergency Contact # _____________________________________ _____________________________________
City: ______________________________________	Peanut Pie is available to schedule classes in your area! Please call Jim Maher at 406-461-3515 for details.
State: ___________________________________
Zip Code: _____________________	Bring Warm Clothes!!!

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