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Public Safety Training Academy

dcolucci@co.morris.nj.us

PO Box 900, Morristown, NJ 07963-0900

973-285-2979

Fire Division Course Registration - Department Submissions

This form is for department use only and must be authorized by the Fire Chief or designee.

If you have any questions about this form, call 973-285-2979.

For FF1, FF2 & Junior courses: See Course Description for Required Paperwork.

Course Start Date

Date Picker

Registrant Information

If a pre-requisite is required for this course, documentation of successful completion (certificate) must accompany registration if not conducted by our staff at the Morris County Public Safety Training Academy.

Registrations will not be processed without required documentation.

Registrant 1

Registrant 2

Registrant 3

Registrant 4

Registrant 5

Registrant 6

Certifications

I hereby certify the listed personnel are covered by Workmen's Compensation and Liability Insurance or otherwise adequately insured. The Academy requires a certificate of insurance from every sending department. Certificates are to updated yearly. Certificates of Insurance requested by the County of Morris must contain the following language: "THE COUNTY OF MORRIS IS AN ADDITIONAL INSURED".

I further certify that any student participating in live fire or S.C. B.A. training has completed the OSHA Respiratory exam and is certified medically fit to wear S.C.B.A.

To the fullest extent permitted by law, the municipality, or agency requesting training for this individual, agrees to defend, indemnify and hold harmless the County of Morris, the Morris County Public Safety Training Academy, and all employees, servants and agents ("the County") from any liability, claims, civil actions, and expenses (including reasonable attorneys' fees) arising out of the training or instruction to be provided at the Academy. Said agreement shall apply, regardless of the allegations made against the County by the officer, this organization, or a third party.

I certify that I have read and agree to the above terms and conditions.

Chief's Name

Department Mailing Address