Reality-Based Training Instructor Registration

Attendee Name

First NameLast Name

Personal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Daytime Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

POST #

TYPE N/A IF YOU DO NOT HAVE ONE. DO NOT LEAVE BLANK.

Agency Name

Training Location

Training Date

By checking this box, I affirm that I have read and understand the prerequisite requirements for the MSA Ground Control System Instructor Course. I acknowledge that this is not a beginner-level course and is intended for experienced practitioners only. I certify that I possess a strong foundation in wrestling, grappling, Brazilian Jiu-Jitsu (BJJ), Judo, or a similar discipline, and that I have the physical ability and technical background necessary to safely participate in this instructor-level training.

My Products

Contracted Agency

For agencies that contract with MSA for CLEE training.

$150.00 Quantity

Non-Contracted Agency

For agencies that are NOT contracted with MSA for CLEE training.

$300.00 Quantity

Total

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.