Lifeline Co
Formal Request to use services.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
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Lead Lifeguard Full Name
Lead Lifeguard Date Of Birth
Lead Lifeguard Years Of Experiance
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Please Describe Your Facilities Emergency Action Plan for a drowning swimmer.
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Facility Location
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nearest Hospital/First Aid location
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Select The Following On site Equipment
• Rescue tube (torpedo buoy)
• Whistle
• Backboard with head immobilizer and straps
• Fully stocked first aid kit
• AED (Automated External Defibrillator)
• Oxygen unit (with masks and regulator)
• Bag-valve mask (BVM)
• CPR pocket mask
• Waterproof radio (or primary communication device)
• Emergency phone or direct EMS communication access
• Public warning flag system (where applicable)
• Posted safety signage (hazards, rip currents, water conditions)
• Designated lifeguard stand or elevated observation point
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Upload image of waterfront from beach
Browse Files
Drag and drop files here
Choose a file
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Upload image of waterfront from lifeguard stand
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Thank you very much for making a request to access the LifeLine Emergency Lifeguarding System. All questions must be filled out in order to be approved. In the next 1-5 Business days we will notify you via email with login credentials (if approved).
By signing below you agree to have facility images processed with geolocation imaging devices to verify the authenticity and location of the photos. You also agree to have the facilities head lifeguard processed in the ULC (United Lifeguard Certification) Program. We do this to ensure that trained and certified lifeguards are on site ready to act.
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