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

Department/Agency Address
Home Address
MM slash DD slash YYYY

Authorized Provider Agency Agreement

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)
Mailing Address of Department/Agency

Fire Chief or Training Officer Authorization

Name of Applicant
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.
MM slash DD slash YYYY

Ice Rescue Instructor Agreement Form

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

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.
MM slash DD slash YYYY