Steep & Multi-Story Equipment Form
Minimum Order of $110 plus shipping and handling
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First Name
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Last Name
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Street Address
Address Line 2
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City
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State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
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Zip Code
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Phone Number
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Email Address
Basic Package Quantity?
Basic Steep Roof Package - $530.00
Basic Package 150' Rope Color?
Red/Black
Orange/Black
Yellow/Black
Blue/Black
Basic Package 6'and 10' Prusik Cords Color?
Green/Blue
Red/Green
Basic Package Choice of Ascender Direction?
Left
Right
Basic Package Choice of Ascender Direction?
Left
Right
Basic Package Harness Type?
Small - Grommet Leg Straps
Small - Quick Release Buckle Leg Straps
Medium - Grommet Leg Straps
Medium - Quick Release Buckle Leg Straps
Large - Grommet Leg Straps
Large - Quick Release Buckle Leg Straps
X-Large - Grommet Leg Straps
X-Large - Quick Release Buckle Leg Straps
Picket Kit (Advanced Anchoring) Package Quantity?
Picket Kit (Advanced Anchoring) - $160.00
Picket Kit 50' Rope Color?
Red/Black
Orange/Black
Yellow/Black
Blue/Black
Picket Kit 20' Tubular Webbing Color?
Green
Red
Blue
Yellow
Orange
How many of each Individual Item?
150' of 7/16" PMI Rope (Red/Black) - $167.10
150' of 7/16" PMI Rope (Orange/Black) - $167.10
150' of 7/16" PMI Rope (Yellow/Black) - $167.10
150' of 7/16" PMI Rope (Blue/Black) - $167.10
150' of 7/16" PMI Rope (White/Black) - $130.00
50' of 7/16" PMI Rope (Red/Black) - $58.00
50' of 7/16" PMI Rope (Orange/Black) - $58.00
50' of 7/16" PMI Rope (Yellow/Black) - $58.00
50' of 7/16" PMI Rope (Blue/Black) - $58.00
Petzl Vertex Vent Helmet - $115.00
CMI Mini U Rack with 2 Hyperbars - $86.25
Hightec-PMI Pulsar Ascender Left Handed - $69.50
Hightec-PMI Pulsar Ascender Right Handed - $69.50
Webb-Rite Tool Belt - $40.00
18 in. R-N-R Edge Pad - $18.50
R-N-R Organizer Gear Bag Black - $98.00
R-N-R Organizer Gear Bag Orange - $98.00
R-N-R Organizer Gear Bag Red - $98.00
Webb-Rite Body Harness - $120.00
Webb-Rite Body Harness Type?
Small - Grommet Leg Straps
Small - Quick Release Buckle Leg Straps
Medium - Grommet Leg Straps
Medium - Quick Release Buckle Leg Straps
Large - Grommet Leg Straps
Large - Quick Release Buckle Leg Straps
X-Large - Grommet Leg Straps
X-Large - Quick Release Buckle Leg Straps
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