Oregon Area Fire & EMS District
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Village of Oregon • Town of Rutland • Town of Oregon • Town of Dunn
February 1, 2017
Dear Fire Citizen Academy Applicant:
On behalf of the Oregon Area Fire EMS District, we would like to thank you for expressing interest in becoming a participant in the Oregon Area Fire EMS District Citizen’s Fire Academy. This program provides participants an opportunity to learn some of the skills and knowledge necessary to perform the duties of a firefighter and Emergency Medical Technician. In addition, each participant will gain valuable insight into the inner workings of the organization. This program is provided at no cost to you.
The Oregon Area Fire EMS District is a combination department consisting of a Fire Chief position, four (4) Captain positions, four (4) Lieutenant positions and twenty-two (22) firefighter and emergency medical technician personnel. Many of these professionals will work closely with each participant to provide you a quality fire academy experience.
Attached you will find an application, release from liability form and an academy syllabus. Please return these forms to the Oregon Area Fire EMS District office, 131 Spring Street in the Village of Oregon, no later than 5:00 p.m., March 31, 2017. Please note that we can only facilitate this program for a total of approximately 10 citizens per each academy. Please do not be deterred if you are not accepted this time, as we plan to make this an annual program.
Thank you again for your interest in the Oregon Area Fire EMS District’s Citizens Fire Academy. If you have any questions, please feel free to contact the department anytime at 608-835-5587, or email .
Respectfully,
Glenn M. Linzmeier, Fire Chief Adam D. King, Citizen Academy Coordinator
Oregon Area Fire EMS District Oregon Area Fire EMS District
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131 Spring Street · Oregon, WI 53575 · P 608.835.5587 F 608.835.8342
www.oregonareafireems.org
CITIZEN'S FIRE ACADEMY APPLICATION
FULL LEGAL NAME:______
Last First Middle
DATE OF BIRTH: ______
FULL ADDRESS: ______
PHONE NUMBER(S): HOME: ______
WORK: ______
CELL: ______
E-MAIL: ______
DRIVERS LICENSE NUMBER AND STATE OF ISSUE: ______
PLACE OF EMPLOYMENT/SCHOOL: ______
Name Address City
DESCRIPTION OF EMPLOYMENT POSITION OR FIELD OF STUDY IN SCHOOL:
______
HOW DID YOU HEAR ABOUT THE ACADEMY?
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1. A background check shall be completed prior to approval to participate in the Academy. If a person wishing to participate is deemed to have an inappropriate record they will be excluded from participation.
2. Participation and questions are encouraged throughout each class!
3. Each class will have approximately 10 participants. District residents get first priority, while those who work in the district second. Dane County residents from other communities are still encouraged to apply.
4. There is no charge for participation.
5. One Academy shall be held annually. Check the Web site for information on dates/times.
Submit your application via mail or e-mail to:
Oregon Area Fire EMS District
Attention: Adam King
131 Spring Street
Oregon, WI 53575
Questions? Call 608-835-5587
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Oregon Area Fire EMS District
Citizens Fire Academy Syllabus
Spring 2017
Instructor: FF/AEMT Adam King
Oregon Area Fire EMS District members
Class Hours: Wednesday's May 3-June 7, 2017 6:00 P.M.-9:00 P.M.
Location: Oregon Area Fire EMS District Training Room
Phone: 608-835-5587
Email:
Course Description: Citizens from the Oregon Area Fire EMS District and surrounding communities will be provided an opportunity to learn some of the skills and knowledge required of a firefighter and emergency medical technician (EMT). Participants shall gain knowledge related to policies, procedures and practices used by the district. Each participant will participate in a variety of classroom instruction and hands on presentations. This program is not a means for any participant to become a certified firefighter and/or EMT.
Academy Course Schedule
May 3rd: Welcome/Introductions, Chief's Welcome, District Organizational Structure, Oregon Fire Department History and Station Tours
May 10th: Fire Science/Training, Fire Code Inspections, Fire Pre-Plans, Anatomy of a Call, Fire
Extinguisher Training
May 17th: Turn-Out Gear, Self-Contained-Breathing-Apparatus (SCBA) demonstrations, Firefighter Equipment, Pump Demonstrations w/ Charged Hose Lines, Search/Rescue
May 24th: Emergency Medical Operations, CPR Demonstration, Backboard Demonstrations, Medical/Trauma Procedures, Ambulance operations, Vehicle Extrication,
May 31st: Technical Rescue/Hazardous Materials, Wildland Fire, Traffic Incident Management, Mock Fire Calls (each participant will put what they've learned to use)
June 7th: Recruitment and Volunteer Opportunities, Q & A, Graduation and Potluck Cookout!
Optional: A scheduled ride-along with on-duty personnel. This will be discussed the first night of the academy.
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OREGON AREA FIRE EMS DISTRICT CITIZEN'S FIRE ACADEMY
RELEASE OF CLAIMS AND INDEMNITY AGREEMENT
I, (please print your name) am not a member of
the Oregon Area Fire EMS District, hereafter known as OAFED, but am voluntarily requesting the opportunity to participate in the Citizens Fire Academy.
1. I am aware that I may be subject to the risk of personal injury, damage to property or even death by participating in the Citizen’s Academy. I freely, voluntarily and with such knowledge completely assume all of these risks.
2. On behalf of myself, my heirs and my assigns, I do hereby agree to indemnify, defend, hold harmless and release OAFED, and their officials, administrators, employees, agents and assigns, from and against any and all liability they may have for any injury, damage, loss or expense, to either me or my property incurred through my direct or indirect participation in various activities included in the Citizen’s Academy which are subject to this agreement, except where such liability results from the sole negligence or willful misconduct of the District.
3. For good and valuable consideration including the service and/or materials being provided, and except when caused by the sole negligence or willful misconduct of the Fire District and its officers, officials, employees and/or agents. I agree on
behalf of myself, my heirs, assigns and the like, to release, hold harmless, indemnify and defend OAFED from and against any and all liability, claims, demands, losses, damages, expenses, costs, including attorney fees, whether to person or property, arising in any way out of services and/or materials provided as indicated in this agreement.
I have read this statement and understand the terms including that I may be giving up certain legal rights by signing this agreement.
The District may terminate my participation in part or all of the activities subject to this agreement at any time and without reason.
I will obey all instructions and directions from any District personnel. I understand that any failure on my behalf to follow the instruction or directions given may be grounds for immediate termination of my participation in this program.
NOW, THEREFORE, for good and valuable consideration and, in consideration of the permission given to me to participate as a guest in an OAFED program and accompany a member or members of the District during various activities, I do hereby agree to all of the above terms and conditions of this agreement. Further, by signing this agreement, I warrant and represent that I have had sufficient opportunity to read this agreement and consider its terms including the indemnification and release information appearing in bold type. I have reviewed this agreement with my counsel, or I have decided freely and voluntarily to forego that opportunity. I understand that I am forfeiting certain rights by signing this document.
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This section must be completed:
Name ______Date of Birth ______
Address ______Home Phone ______
______Work Phone ______
E-mail address: ______
Health Insurance Provider______
(Note: Individuals applying for participation in the Citizen’s Academy must have health insurance.) (This may be parent’s coverage for students attending high school/college/technical college/university.)
Emergency Contact ______
Relationship ______
Emergency Contact Phone______
THE UNDERSIGNED HAS READ THIS DOCUMENT IN ITS ENTIRETY AND UNDERSTANDS
THAT CERTAIN LEGAL RIGHTS ARE OR MAY BE FORFEITED BY VOLUNTARILY SIGNING
THIS AGREEMENT BELOW.
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Signature of Program Participant Date
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