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Ever wonder what it would be like to be a Firefighter? HERE IS YOUR CHANCE! WISSAHICKON FIRE COMPANY’S 2011 Tuesday Nights in July! July 5, 13, 20 & 27 – 7:00 pm-9:30 pm TEENS & ADULTS! Ages 14 & above! Boys & Girls! Join us for a fun 4-night program where you’ll experience what it’s like to be a Firefighter with Reallife, Hands-on Experiences! • Fire Behavior • Protective Clothing • Breathing Apparatus • Extinguishers • EMS • Engine Company Operations • Ladder Company Operations • Rescue Operations • Firefighter Tools Learn from Experienced Firefighters! What’s Included in Firefighter Camp? 4 Nights of Real-Life, Hands-On Firefighter Experiences Using Extinguishers; Establishing Water Supplies; Attacking Fires; Throwing Ladders; Conducting Search & Rescue; Operating Thermal Imaging Cameras; Using Self-Contained Breathing Apparatus Instruction by Certified Instructors & Firefighters FF Camp T-Shirt, Snacks & Beverages On the Last Night, Participants will: • Demonstrate the skills they’ve learned in their own Fire Suppression Demonstration • Meet local Fire Chiefs • Have a Barbecue with their family & friends FIREFIGHTER CAMP REGISTRATION FORM To reserve your space, send the following to: Camper Information: Wissahickon Fire Company, Attn: FF Camp 245 E Race Street, Ambler, PA 19002 Name ________________________________ Completed Registration Form T-Shirt Size: (Adult) S M L XL 2XL $20 Check payable to: “Wissahickon Fire Company” Date of Birth _______________ Age: _______ Home Phone: __________________________ All campers will be under the direct supervision of experienced certified Firefighters and Instructors. Mailing Address RELEASE/WAIVER OF LIABILITY/INFORMED CONSENT – RELEASE: I give my permission for the child named above to attend the Wissahickon Firefighter Camp. I understand the program will involve a variety of physical activities and I verify that my child is in proper physical and emotional condition to participate in these and other activities conducted during camp. I assume all risks and hazards incidental to the conduct of this program and waive, release, absolve, indemnify, and hold harmless the Wissahickon Fire Company and its members, except in cases where negligence is proven. AUTHORIZATION FOR TREATMENT – In the event I cannot be reached in an emergency, I hereby give permission to the Wissahickon Fire Company to secure and administer treatment, including hospitalization, for my child as named above. PHOTO – I give permission for my/my child’s photo to be used in promotional materials. _____________________________________ Parent/Guardian Signature (If Camper is under 18) E-Mail address_________________________ Grade in September 2011 _______________ Name of School _______________________ How did you hear about the Firefighter Camp? _____________________________________ _____________________________________ Note special health concerns or dietary restrictions: _____________________________________ _____________________________________ Parent/Guardian 1: Name _______________________________ Home Phone: _________________________ Day Phone: ___________________________ Parent/Guardian 2: X Camper Signature X _____________________________________ Date Name ________________________________ Home Phone: _________________________ Date Day Phone: ___________________________