Other

Live Fire Trailer Training Schedule ----- please look to see if dates are available for your personnel -----

Student Form – Complete one per student

Instructor Form – To be completed by the PRIMARY INSTRUCTOR

Facility Training Waiver – To be completed by the SAFETY OFFICER/INSTRUCTOR

Participant Requirements: By signing your course documents each individual is attesting that he/she has received training in the following areas.

Safety	Fire Behavior
Portable Extinguishers	Personal Protective Equipment
Ladders	Fire Hose, Appliances and Streams
Overhaul	Water Supply
Ventilation	Forcible Entry

If you are certified at the mandatory or Firefighter I level you exceed these requirements.

Liability Waiver Form

for

Training using the “Live Burn Trailer”

I, __________________________, understand that the Indiana Department of Homeland Security (“IDHS”), its employees and agents are not responsible for and will not be liable for any injury to myself or my property that may occur in connection with my participation in training using the “Live Burn Trailer” and I hereby agree to indemnify and hold harmless the State of Indiana, IDHS from loss, liability, damage or cost, including attorneys’ fees and costs of litigation I may incur due to my participation in training using the “Live Burn Trailer”.

I understand that my remedies in the event that I am injured due to my participation in training using the “Live Burn Trailer” are workers’ compensation, if I am participating in the training as part of my employment, or other medical insurance that may be available to me as a volunteer or career firefighter.

Signature _____________________________________________

Date ________________ Printed Name:______________________________________

FDID No or FD Name __________________________ PSID # ___________________

New Castle Fire Department “A” Shift less 2 (w/Chief)

Left to Right

Kent Keith, Fred Thurman, Bobby Wallen, Chief Jeff Murray, Kevin Lykens, Ron Huffman, Dave Scarrette, Kevin Webb