Active Shooter Exercise Registration 2018
Event Timing: July 2, 2018
Event Address: Penn High School, 56100 Bittersweet Road, Mishawaka, Indiana 46545
Contact us at (574)258-9551 or (574) 258-9535
Exercise:  Waivers and identification of participants opens:  8AM to 9AM only.

This Community Exercise is for school personnel only.  Participants may be P-H-M Staff or High School age students only.  School Safety Specialists are invited to participate from other school districts or school staff from adjoining school districts of PHM Schools.   All participants must show a school identification and provide a signed waiver prior to access to this exercise and event.   The public is not permitted to attend this important event.
Last Name *
First Name *
Email *
School or Organization *
Are you a student, staff or other *
Do you want Professional Growth Points (PGP's) for this training? *
Required
I will be taking an ACTIVE role in this training exercise. *
Required
I will only be an observer or extra in this exercise.
I agree to sign a release and waiver of liability, assumption of risk, and indemnity agreement *
Required
I agree to release my FERPA rights for purposes of using this exercise as a training video for schools. *
Required
Please indicate if you are one of the following: *
Required
If school other than PHM Schools, what school district are you a student or staff member *
Lunch Dietary restrictions *
I understand that if a student, my waiver must be signed by my parent, guardian or custodian prior to the exercise.  Without the signed waiver, you will not be permitted access.  The responsibility of the student and active participation in this event is understood by the parent, guardian or custodian. *
Required
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