Event registration for the 2018 Auburn Fire and Rescue Junior Firefighter Academy
Event Timing: June 11-15, 6:30-8:30 p.m.
Event Address: 117 W. Jackson St., Auburn, IL
Contact us at (217) 899-0525 or revans@auburnfireandrescue.org
Email address *
Participant's Full Name: *
Your answer
Grade Entering in August 2018? *
Gender: *
Birthdate: *
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Home Address: (number street, city) *
Your answer
Participant's t-shirt size (choose one) *
Parent/Guardian Name: *
Your answer
Parent/Guardian Phone Number: *
Your answer
Alternate Contact Number: *
Your answer
If the participant is planning on attending the Academy with a friend, please list the friend(s) name(s):
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Please list all health concerns, limitations, restrictions or medications for your participant:
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By checking the box below, I am stating that I am 18 years or older in age. I have legal right to sign up the above mentioned participant for this event. *
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Auburn Fire and Rescue Junior Firefighter Academy
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