If you have 10 or more persons to be trained....we will schedule a class at your location that will fit your schedule. Call 1-800-341-4898 for details on your own class at your location .

All training courses will be held at Haz-Training Institute's Regional Training & Simulation center unless otherwise noted. The location is 6801 N Hwy 79 Suite #1 in Black Hawk, SD. We are located in the southwest corner of the building marked 6801. (The old Star Center in Black Hawk…between Cedar and Pine St … just 4 blocks south of BJ’s Country Store.  Haz-Training Institute's classroom is in Suite 1.)

Applicants are accepted according to date application is received. Classroom space is limited; applications taken on a “first-come first-serve” basis. The agency agrees to pay the amount due for the number registered. Substitutions for pre-registered persons will be accepted on the first day of class. 

For additional registrants, please fill this form out for as many as are registering for this class (contact us for multiple person discounts).

Payment or a purchase order and a faxed confirmation form (which you'll receive upon submission of this form) must be received within 10 days of the date on this registration unless its via mailed check (mailed checks must be mailed within 10 days)-- or the registration is not valid. (Credit card phone payments are accepted, call 1-800-341-4898). All payments must include 4% SD sales tax (unless you are tax exempt).

Cancellation / Reschedule Policy 
Unless you notify us within 24 hours from the date you register, the following fees will apply:

1. All cancellations/reschedules will receive a 25%     administrative fee if not cancelled within 24 hours.

2. Any cancellation/reschedule received less than 7 business days prior to class start will be charged a 50% fee.

3. Any cancellation/reschedule received inside of 24 hours of the class date, no refunds will be issued. This includes no-shows. You may be able to receive credit towards a future course.

4. Occasionally our scheduled seminar dates, times, and locations are subject to cancellation or postponement due to circumstances beyond our control. In the event a class is cancelled Haz-Matters is liable only for the full registration fee.

  I, the herein listed person, understand, agree, and accept the terms and conditions described herein.
    ----------------------------------------------------------------------------------------------------------------------------------

  I, the herein listed person, understand, agree, and accept that: No warranty, guarantee, or representation expressed or implied is made by or on behalf of Haz-Training Institute as to the absolute correctness or sufficiency of any representation contained in the courses or its documents. Haz-Training Institute assumes no responsibility in the connection therewith, nor can it be assumed that all acceptable safety measures are contained in the courses or its associated documents or that, other additional measures may not be required under particular or exceptional conditions or circumstances.
    -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

-- mm/dd/yy

Enter the date(s) of the class from the schedule sheet, if you don't know it or the class isn't scheduled yet, enter: 0.

I want a wallet card only! I want an 8 x 10 wall certificate only! I want both certificates!

Please, send me e-mails on upcoming classes.
Please, send me e-mails on health and safety issues.
Please, send me information on Haz-Matters, Inc.
Please, do not send me e-mails.

Any other information  or questions -- please type here.

Method Of Payment: Choose a payment method and fill out the information below.
        To determine the amount for the payment amount multiply the course fee by 4%, if you don't know the course fee go to-- HTI Class Schedules or call 1-800-341-4898.

a.  I will call 1-800-341-4898 for a phone credit card order.

b.   Check will be sent by mail.                 

c.   Purchase Order #     

To pay via Credit Card select the card you are planning to use then- upon submitting this Registration Form a "Class Registration Fax Form" will show, please print out the fax form and then fill in the information (card # , name, and expiration date) and fax the form to Haz-Training Institute.

d.     Mastercard

d.     Discover

d.     American Express 

e.   Visa 

               --  Print name as it appears on card:    

               --  Person to Contact about payment:

___________________________________________________________________________________________________________________________________________________________________

After submitting this form, a Class Registration Fax Form will show with the information you have submitted in this form. Please, print a copy of the fax form, fill in the blanks on the page, sign it, and then fax the form to Haz-Training Institute . Haz-Training Institute must then received payment within 10 days of date on this registration form for complete registration of the classes requested.