Ice Rescue Instructor Course Materials

There are two sections to this confirmation.

You must review both. (1) The Instructor Packet, (2) Required Forms.

Ice Rescue Instructor Candidates

Section 1: Instructor Candidate Packet

The Instructor Candidate Packet contains all information and required reading for Instructor Candidates.

Instructor Candidate Confirmation Packet (pdf)

Instructor Candidate Confirmation Packet (Word Document)

Section 2: Required Forms

There are four required forms below.

These documents must be submitted prior to the academy.

They may be submitted online, below, or you may print from the Instructor Candidate Confirmation Packet and email to our office at [email protected].

Be sure to hit “SUBMIT” after completing each form.

Ice Rescue Instructor Contact Form

Name

First Last

Cell Phone

Department

Title

Department/Agency Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Digital Signature

Date

Authorized Provider Agency Agreement

This represents an agreement between LIFESAVING RESOURCES, LLC and the below named agency for the conduct of Lifesaving Resources' Ice Rescue Awareness, Operations, and/or Technician level courses on behalf of your department/agency.

As an Authorized Provider Agency, your department/agency agrees to support the designated representative listed below who has been trained and authorized by Lifesaving Resources as an Ice Rescue Instructor.

Instructors must adhere to all Policies and Procedures established by Lifesaving Resources in the conduct of these courses. To be eligible for re-authorization, Instructors must conduct a minimum of 2 courses within their authorization period, one of which must be a Technician-level course.

While teaching Lifesaving Resources’ courses, Instructors are required to use the most current powerpoint/keynote presentation and Instructor’s SOP Manual, both of which are available online through the Instructor’s Portal.

Each student participating in a Lifesaving Resources' Ice Rescue course must receive his/her own personal copy of the latest Ice Rescue Course Guidebook version, and upon successful completion of their training, they must be issued a Lifesaving Resources’ Course Completion Certificate and Insignia.

The cost for the required guidebook is approximately $20 per guidebook. Failure to adhere to the established Policies and Procedures will invalidate this agreement and your representative's authorization as an Ice Rescue Instructor.

Lifesaving Resources agrees to support your designated representative as follows:

1. Provide technical support to Instructors in the conduct of Ice Rescue Courses at the Awareness, Operations and/or Technical level.

2. Provide current and up-to-date educational materials (student guidebooks, videotape segments, Instructor Manuals, presentations).

3. Provide Course Completion Certificates and Insignia.

Name of Instructor (Your Name)

First Last

Name and Title of Chief Training Officer

Type Name as DIgital Signature of Chief Training Officer

Mailing Address of Department/Agency

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your Phone

Your Email

Fire Chief or Training Officer Authorization

Name of Applicant

First Last

I hereby consent for the applicant to participate in the International Ice Rescue Instructor Academy and verify that he/she is covered by our department (or company) insurance, is not receiving workmen’s compensation at this time, and his/her physical fitness level is appropriate for the course requested.

I also am confident that the above named has the aptitude and cognitive learning skills to comprehend this level of education.

Digital Signature of Fire Chief/Training Officer:

Date

Fire Chief/Training Officer Email

Fire Chief/Training Officer Phone

Department/Agency Name

Ice Rescue Instructor Agreement Form

This is to certify that

has successfully completed a Lifesaving Resources' Instructor Academy in Ice Rescue and is authorized to conduct Ice Rescue Awareness, Operations, and Technician Level Courses on behalf of Lifesaving Resources and

Name of Agency

By signing this Agreement, the above-named individual agrees to adhere to all policies and procedures established by Lifesaving Resources in the conduct of these courses and to represent Lifesaving Resources and the Authorized Provider Agency to the best of his/her ability.

Signature of Authorized Instructor or Instructor Candidate

Date