Blue Grass Airport | Lexington, KY

Class Registration Form

ARFF CLASS SELECTION

All Fields are Required

First Name

Last Name

Organization

Work Address

City

State / Province

ZIP / Post Code

Country

Work Phone

Work E-mail

Confirm work E-mail

Personal Phone

Emergency Contact Name

Emergency Contact Phone

Dept. Head/Chief Name

Dept. Head/Chief Phone

Dept. Head/Chief Email

Medical Conditions

Allergies

Fire Fighting Experience

Airport Experience

Receive additional training class updates and schedules via email.

INDIVIDUAL RELEASE OF LIABILITY FOR ARFF TRAINING

In consideration of receiving aircraft rescue and firefighting training at the Blue Grass Airport Regional ARFF Training Center, Versailles Road, Lexington, Kentucky, hereby unconditionally release and forever discharge Blue Grass Airport and the Lexington-Fayette Urban County Airport Board, their officers, directors, agents, representatives, and employees (hereinafter ³Releasees²) from any and all claims, liabilities and causes of action which I might have against the Releasees as a result of any injury or damages I sustain while participating in the training, in traveling to or from the training site, or in any way resulting from the training either during or after my participation in it, including injuries or damages resulting from the ordinary negligence or gross negligence of Releasees, as well as any claims third parties may have in any way resulting from the negligence or intentional misconduct of it or its personnel in the course of the training. This Release does not apply, however, to intentional, willful or wanton conduct by the Releasees.

I agree that:

1. I have been briefed about this training and I am familiar with the type of physical ability necessary to participate in this training, and to the best of my knowledge, my health and physical condition are excellent and I am capable of undertaking this training.

2. I am fully aware this training necessarily involves certain inherent and hazardous risks, and I voluntarily assume all risks this training presents, and request that I be given an opportunity to participate in this training.

3. I am fully aware that this Release does not constitute a waiver by the Blue Grass Airport, Lexington-Fayette Urban County Airport Board or the Lexington-Fayette Urban County Government of their defense of governmental immunity, or any other defense recognized by the statues and common law of this Commonwealth.

4. I have read and fully understand the terms and conditions of this Release of Liability and further understand that the opportunity to participate in this aircraft rescue and firefighting training is afforded by the Blue Grass Airport based upon my signing this document and that if I refuse to sign this Release I cannot participate in this training. However, I also understand that my refusal to sign the Release and my failure to participate in the training will not result in any adverse action against me by my unit/department.
Check and Initial to indicate waiver acceptance.

SELECT AND COMPLETE ONE PAYMENT TYPE

Pay by Credit Card

Cardholder Name

Card Number

Expiration Date

Use MM-YYYY date format.

CVV

Billing Address Line 1

Billing Address Line 2

City

State

ZIP

Pay by Check

If selecting this option, an invoice will be generated in your registration confirmation. Payment is required on or before the first day of class.

SPD CODE

If you were issued an SPD Code, enter it here.

REQUIRED EQUIPMENT

All participants are required for providing the following equipment. For those traveling by air, where equipment transport may be difficult, contact the training center staff to inquire if alternate arrangements are available.

Required Equipment:
•Bunker coat/pants
•Fire gloves
•Fire boots (leather or rubber)
•Fire helmet
•Nomex hood
•SCBA with one bottle (two preferred)



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