Water Rescue Instructor Course Materials

There are two sections to this confirmation.

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

Water 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 three 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.

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

This represents an agreement between LIFESAVING RESOURCES, LLC and the below named agency for the conduct of Lifesaving Resources' Water Rescue Awareness, Operations, and/or Technician level courses, and Swiftwater/Surf Rescue Technician 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 a Water 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, they must conduct a minimum of 2 courses within their authorization period, one of which must be a Technician-level course. Each student participating in a Lifesaving Resources' Water Rescue course must receive his/her own Water Rescue Course Guidebook, and upon successful completion of their training, they must be issued a Lifesaving Resources’ Course Completion Certificate. The cost for the required guidebook is currently $19.50 per person.

Failure to adhere to the established Policies and Procedures will invalidate this agreement and your representative's authorization as an Water Rescue Instructor.

Lifesaving Resources agrees to support your designated representative as follows:

1. Provide technical support to Instructors in the conduct of Water 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).

3. Provide Course Completion Certificates and Insignia (optional).

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

Name of Applicant

First Last

I hereby consent for the applicant to participate in the Water Rescue Technician Course 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, cognitive learning skills, and physical ability to comprehend and participate in 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