Request for Public Education

Print
Press Enter to show all options, press Tab go to next option
Please correct the field(s) marked in red below:

REQUESTS FOR GROUPS OUTSIDE OF ELEMENTARY SCHOOLS:

 

If you are requesting a presentation for an organization outside of an elementary school, Public Education programming is available Monday through Saturday, with the exceptions of Wednesday evenings and Tuesday mornings.

Due to staffing levels, the Department is unable to provide the following services:

  • Fire Extinguisher Training
  • Business Fire Escape Planning
  • Observation of Fire Drills
  • Car Seat Check-Ups
  • Birthday Parties at Fire Stations

 

As emergency responders, we are unable to predict our call volume on any given day.  Because of this, there are times when we have to cancel prescheduled appearances.  We will do our best to notify you in advance of any cancellation and ask that you follow up with us to reschedule the appearance.

 

To help us process your request, please answer the following questions. We will respond to your request within 48 hours.


Please Note: (*) indicates responses are required.


First Name
 *
Last Name
 *
Cell Phone Number
 *
Alternative Phone Number
Email Address
 *
Location Name
 *
Location Address
 *
Location Address
Estimated Number of Participants
 *
Age of Audience (Select all that apply)
 *
Age of Audience (Select all that apply)
Type of Request
 *
Type of Request
Is the date of your event flexible?
 *
Is the date of your event flexible?

Select the date you are requesting

(Wednesdays 6:30-8:30 p.m. and Tuesdays 8:30-11:30 a.m. are not available)

 *
Select a time frame that will work for your request date
 *
Select a time frame that will work for your request date

Alternative date for your request

(Wednesdays 6:30-8:30 p.m. and Tuesdays 8:30-11:30 a.m. are not available)

 *
Select a time frame that will work for your alternative date
 *
Select a time frame that will work for your alternative date
Additional Information

Waivers

Liability Waiver: In consideration of your accepting this entry, I state and affirm that participation in the above program(s) is voluntary.  I understand that the program(s) are not an essential service provided by the City; that certain risks are inherent and that these risks, anticipated or unanticipated, may result in injury or damage to persons and/or property.  I hereby assume all risks in connection with the program(s); agree to hold the City or anyone acting on behalf of the City harmless and waive any right to make claims or bring lawsuits for any injuries or damages related to the alleged negligence of the City.  This waiver does not apply to any injuries or damages that are a result of willful, wanton or intentional misconduct by the City or anyone acting on behalf of the City.

Photo Waiver:  I understand that the City may use photographs taken at its programs that picture me or my dependents for publicity purposes.

 *
  1. To receive a copy of your submission, please fill out your email address below and submit.