REGISTER NOW!FASNY HANDS-ON TRAINING

BOOT CAMP

3-HOUR HANDS-ON SKILLSStation 1: Forcible EntryStudents will be working in teams of two to make entry to inward opening doors. Doors range in difficulty from one lock to multiple locks, both high and low. Using the “gap, set, force” technique, the students will have plenty of hands-on time to operate both the halligan and the ax. Minor modifications to the halligan will be shown, as will the differences between a six- and eight-pound ax in addition to a maul.

Station 2: Firefighter BailoutWith bailout systems being a best practice in the state of New York, firefighters must train with them to be proficient. Regardless of the system used, the basics of tying remotely or hooking into the window sill and the exit remain the same. Firefighters will have the opportunity to practice with their own systems or try other systems available. Firefighters will perform bailouts using a remote anchor and a window sill deployment with an emphasis on control and a smooth descent to the ground. Safety belays systems will be in place.

Station 3: Roof VentilationFirefighters will perform vertical ventilation on a 25-degree pitch roof. Firefighters will practice ascending both with an extension ladder and a roof ladder while sounding the roof and getting all of the required equipment to the roof. Members will then make cuts using a ventilation saw while being assisted by a partner. The emphasis for this station will be on safety and operation of the saw while on a peaked roof.

Complete registration form on reverse side or visit fasny.com to register!

Student Information (Please Print)

Name: ______________________________________________________________________________________________________

Address: _________________________________________________________FASNY Member Number: _________________________

City: _______________________________________________________________State: ___________ Zip: _____________________

Phone Number: ____________________________________________ Cell Phone: ___________________________________________

Email Address: ________________________________________________________________________________________________

I, ________________________________________________________, have read, fully understand and agree with the above information. PRINT NAME OF FIREFIGHTER

I understand and acknowledge the importance of safety during the training course and further acknowledge that if an instructor believes that my behavior or abilities may cause a safety risk to myself or others, the instructor has the authority to remove me from the simulation or course.

________________________________________________________________________________________________________________ _______________________________________________________________SIGNATURE OF FIREFIGHTER DATE

Please Select Your T-shirt Size (Pre-Registered Attendees ONLY)

£ Small £ Medium £ Large £ XLarge £ XXLarge £ XXXLarge

Fire Chief Authorization (Please complete information below) To the Firemen’s Association of the State of New York:

The firefighter listed above is an active member of __________________________________________ Fire Department and is authorized to attend the course indicated. I understand this training course contains certain evolutions that simulate and/or create actual firefighting or rescue conditions. The Firemen’s Association of the State of New York is not responsible and/or liable for any malfunction or damage to any equipment used during this training program.

The firefighter is physically and medically able to perform firefighting operations. £ YES £ NO

The firefighter listed above will be equipped with proper PPE in accordance with 29 C.F.R. part 1910.132. £ YES £ NO PPE: Turnout gear, helmet with eye protection, firefighting gloves, hood and footwear are required. An SCBA with spare cylinder is optional.

The firefighter has successfully completed Firefighter 1 or equivalent. £ YES £ NOPrint Chief’sChief’s Name: ____________________________________________ Signature: __________________________________________

Payment Information

Registrant must be an individual member for discount. Pre-registration deadline is five (5) business days prior to training date. $75/FASNY members – $90/non-FASNY members.

No-shows and cancellations are non-refundable unless a written notice is received five (5) business days prior to the training date.

FASNY Hands-On Training Boot CampEach participant MUST complete this form in its entirety before submission to the FASNY office.

Please Select Your Course Location – 30 Students Maximum Per Location. Onsite check in starts at 5:30 p.m., Boot Camp starts at 6:00 p.m. Note: 30 student max (10 students per station in a rotation – breaks at rotation)

Niagara County – Tuesday, September 26 Frontier Fire Company: 2181 River Road, Niagara Falls

Ontario County – Wednesday, September 27 Hopewell Fire Department: 4018 State Route 5&20, Canandaigua

Oneida County – Thursday, September 28 Maynard Fire Department: 9500 Maynard Drive, Marcy

Essex County – Tuesday, October 3 Lake Placid Fire Department: 456 Old Military Road, Lake Placid

Albany County – Wednesday, October 4 Onesquethaw Fire Company: 2177 Tarrytown Road, Clarksville

Dutchess County – Thursday, October 5 Pleasant Valley Fire Station #1: 1619 Main Street, Pleasant Valley

Pre-Registration Information:

_________ FASNY Members @ $75 each = $_____________

_________ Non-Members/On-Site @ $90 each = $_____________

Grand Total Due: $_____________

Mail this form with payment (vouchers and purchase orders accepted) to: FASNY Office

107 Washington Avenue Albany, NY 12210-2269

Credit Card Information:

Card #____________________________________________

£ American Express £ MasterCard £ Visa

Expiration Date____________/___________ (month/year)

CVN #____________________________________________

Name on Account___________________________________

Billing Address (if different) ___________________________

City: _______________________State:______ Zip:________