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Florida Mine Safety
Health & Training Program
About
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2024 Competition
2025 Competition
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About
Who We Are
Advisory Board
Partners in Safety
Courses
Competition
2024 Competition
2025 Competition
Events
Workshops
Media
Careers
MSIA
Contact
Team Competition Registration
"
*
" indicates required fields
Step
1
of
6
16%
Team Registration - $1,500
Team registration includes Monday's activities, Meet & Greet with Dinner, Banquet entry, and all meals on Wednesday and Thursday. Attendees will also have access to spectator and viewing areas, with an optional extra Banquet guest add-on available.
Team Name:
*
Company Name:
*
Company Address:
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Which Rules Do You Wish Your Team To Be Judged By:
*
National Rules
Regional Rules
Does Your Team Qualify for Novice Team?
Novice Teams (if requested) are defined as a team that is within the firsts 2 years of competing.
Yes
No
Team Contact Name:
*
First
Last
Team Contact Email :
*
Team Contact Phone:
*
Number of Members on Team
*
(Minimum of 3 Team Members and Maximum is 10 Team Members.)
Team Members
A Team is defined as three to 9 Team Members and one Team Trainer. Additional Team Trainers will need to register as Non-Competitors.
Team Captain Name:
*
First
Last
(The Team Captain is the designated Team Member 1)
Team Captain Shirt Size:
S
M
L
XL
XXL
Team Captain Glove Size:
S
M
L
XL
2XL
3XL
Do you have a Team Trainer?
*
No, we do not have a Team Trainer
Yes, we have a dedicated Team Trainer
Yes, we have a Team Trainer who serves as Team Captain too
Team Trainer Name:
First
Last
Team Trainer Shirt Size:
S
M
L
XL
XXL
Team Trainer Glove Size:
S
M
L
XL
2XL
3XL
Team Member 2 Name:
*
First
Last
Team Member 2 Shirt Size:
*
S
M
L
XL
XXL
Team Member 2 Glove Size:
*
S
M
L
XL
2XL
3XL
Team Member 3 Name:
*
First
Last
Team Member 3 Shirt Size:
*
S
M
L
XL
XXL
Team Member 3 Glove Size:
*
S
M
L
XL
2XL
3XL
Do you have more than 3 team members? If so select the correct number below:
*
No
Yes, we have 1 more team member
Yes, we have 2 more team members
Yes, we have 3 more team members
Yes, we have 4 more team members
Yes, we have 5 more team members
Yes, we have 6 more team members
Yes, we have 7 more team members
Team Member 4 Name:
First
Last
Team Member 4 Shirt Size:
S
M
L
XL
XXL
Team Member 4 Glove Size:
S
M
L
XL
2XL
3XL
Team Member 5 Name:
First
Last
Team Member 5 Shirt Size:
S
M
L
XL
XXL
Team Member 5 Glove Size:
S
M
L
XL
2XL
3XL
Team Member 6 Name:
First
Last
Team Member 6 Shirt Size:
S
M
L
XL
XXL
Team Member 6 Glove Size:
S
M
L
XL
2XL
3XL
Team Member 7 Name:
First
Last
Team Member 7 Shirt Size:
S
M
L
XL
XXL
Team Member 7 Glove Size:
S
M
L
XL
2XL
3XL
Team Member 8 Name:
First
Last
Team Member 8 Shirt Size:
S
M
L
XL
XXL
Team Member 8 Glove Size:
S
M
L
XL
2XL
3XL
Team Member 9 Name:
First
Last
Team Member 9 Shirt Size:
S
M
L
XL
XXL
Team Member 9 Glove Size:
S
M
L
XL
2XL
3XL
Team Member 10 Name:
First
Last
Team Member 10 Shirt Size:
S
M
L
XL
XXL
Team Member 10 Glove Size:
S
M
L
XL
2XL
3XL
Monday Evening Activites
Will any team members participate in the Monday evening activities?
*
Monday evening activities are optional.
Yes
No
Monday Training Classes
Please CONFIRM your course registration(s) by checking the box(es) labeled "Yes, I'd like to register for this session." Leaving this box unchecked will invalidate your course registration.
Will you be registering members of your team to attend Monday Training Classes?
*
Please register for only one 8-hour course per day.
Yes
No
Monday, February 24, 2025: Confined Space and Rope Rescue ($60.00 per person)
Firearms Classroom Building - Room 118 and Training Tower - Class is from 6:00 am – 3:00 pm
Yes, I’d like to register for this session
# of Attendees being Registered
Names of Attendees
Monday, February 24, 2025: 1st Aid Refresher, CPR and AED Practice ($60.00 per person)
Defensive Tactics Building - Room 112 - Class is from 6:00 am – 3:00 pm
Yes, I’d like to register for this session
# of Attendees being Registered
Names of Attendees
Monday, February 24, 2025: Basic Firefighting, Vehicle Extrication and Awareness Level Hazmat ($60.00 per person)
2964 Municipal Way, Tallahassee, FL 32304 - Class is from 6:00 am – 3:00 pm
Yes, I’d like to register for this session
# of Attendees being Registered
Names of Attendees
Monday, February 24, 2025: CDC/NIOSH Mine Rescue Training Platform Testing ($60.00 per person)
DJJ Classroom Building - Rooms 007 & 008 - Session 1 is from 6:00 am - 10:00 am & Session 2 is from 11:00 am - 3:00 pm
Yes, I’d like to register for this session
# of Attendees being Registered
Names of Attendees
Monday, February 24, 2025: Horizonal Confined Space Rescue ($60.00 per person)
Location TBD - Class is from 6:00 am - 3:00 pm
Yes, I’d like to register for this session
# of Attendees being Registered
Names of Attendees
Florida Public Safety Institute Housing
For any questions about lodging, please contact Karen Miller at Karen.Miller@tsc.fl.edu or (850) 201-7689.
Are you interested in housing?
*
Yes, I’m interested in housing
No, I am not interested in housing
Date In:
*
MM slash DD slash YYYY
Date Out:
*
MM slash DD slash YYYY
# of Single Rooms to Reserve ($36 per room per night):
*
0
1
2
3
4
5
6
7
8
# of Double Rooms to Reserve ($29 per bed per night):
*
0
1
2
3
4
5
6
7
8
Are you bringing additional guests to the Awards Banquet (includes a reception and dinner) for a fee of $50 per guest?
*
Yes, I'm bringing additional guests
No, I'm not bringing additional guests
# of Additional Awards Banquet Guests
*
Name
This field is for validation purposes and should be left unchanged.
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