Citizen Fire Academy Registration Form

Registration Form

Fill out the form carefully for registration into the Hopkinsville Fire/EMS's 2026 Citizen Fire Academy held at Fire Station 5 (101 Walton Way Hopkinsville, KY 42240)
Participant Name

First NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.
Additional Comments/Concerns
T-Shirt Size (S-3XL)
By submitting this form, the participant understands that their participation in this program is completely voluntary. A signed liability waiver is required for all participants on the first night of class.

Minimum age to participate is 18 years of age.
Should be Empty: