• Image field 127
  • Image field 128

  • EDINBURG TEEN FIRE ACADEMY

    APPLICATION FORM

  • PLEASE PRINT: Completed application must be received by June 22, 2026.

  • PARTICIPANTS INFORMATION

  • Select Class Dates:*
  • Date of Birth:*
     - -
  • Format: (000) 000-0000.
  • T-Shirt Size:*

  • PARENTS INFORMATION

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • ADA Accommodations Needed:*

  • EMERGENCY CONTACT

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Date:*
     - -

  • HEALTH & EMERGENCY CARE FORM

  • Important: The Following Must Be Completed For Attendence

  • Format: (000) 000-0000.

  • The following questions are in regards to the participant. The below information will be given to any emergency medical technician (EMT), paramedic or health care professional providing treatment. The form will also be given to a doctor if an emergency room visit is recommended. Please fill out the following questionnaire to the best of your knowledge and explain any medical conditions that your child may have, in full detail.

  • Has your child had any recent injury, illness or infectious disease?*
  • Has your child ever been hospitalized and/or had any surgeries?*
  • Does your child have any orthopedic problem (i.e.: bones, joints, ligaments and muscles)?*
  • Does your child have any physical limitations or wear orthopedic braces?*

  • Does your child have a history of: (Please check off Yes or No)

  • Asthma*
  • Headaches*
  • Ear Infections*
  • Fainting Spells*
  • Diabetes*
  • Heart Trouble*
  • Difficulty w/Digestion*
  • Convulsions/Seizures*
  • Date:*
     - -

  • MEDICAL HISTORY - CONTINUED

  • Are you allergic to any medications?*
  • Are you allergic to any foods?*
  • Do you have any special dietary needs?*
  • Are there any other medical conditions that are not listed above?*
  • Do you take any medications that will need to be taken during the program hours (9:00 am – 3:00 pm)?*
  • Date:*
     - -

  • APPROVAL & AGREEMENTS

  • PLEASE READ CAREFULLY

  • 1. PARTICIPATION AUTHORIZATION: I hereby grant permission for the child named on this form to participate any or all of the programs sponsored by the Teen Fire Academy. I understand that my child may be transported to other sites for additional activities during the course of their participation in the program and I agree to hold harmless the City of Edinburg, its employees and volunteers for injuries or damages resulting from my child's participation.

  • 2. EMERGENCY TREATMENT: Employees of the City of Edinburg participating in the Teen Fire Academy have permission in the event that I cannot be reached in an emergency, at my expense to (1) contact our family physician, or (2) utilize the most convenient rescue squad, vehicle, or ambulance to transport my child to the nearest hospital.

  • 3. PHOTOGRAPHS: By signing this form, I give permission for my child/myself to be photographed and/or videotaped by the City of Edinburg and public media, unless a separate request not to photograph is submitted. I understand that the photograph/video will be used to promote the Teen Fire Academy and I give permission for that use.

  • 4. RULES OF CONDUCT: I understand my child must comply with the rules defined by staff and maintain self-control and act responsibly while participating in the program.

  • 5. LIABILITY WAIVER: In consideration of the City of Edinburg Fire Department, granting my child permission to attend the Teen Fire Academy, I hereby waive any and all risks and liability for damages, losses, personal injuries, or death which my child might suffer, sustain or cause while participating in the Teen Fire Academy. I further waive any and all claims, demands, actions, damages or suits at law or equity of whatever nature which I have or may hereafter acquire against the City of Edinburg Fire Department, officers, firefighters, agents, or employees as a result of my child's voluntary participation in the Teen Fire Academy and I hereby hold harmless such persons and entities. In the event that a demand or claim, whether groundless or otherwise, is made against the entities and or persons set forth herein, I agree to indemnify those persons and/or entities for all damages, attorney fees, and costs incurred in defending said demand or claim. I hereby acknowledge that I fully understand the consequences of this waiver and that it is a voluntary and intelligent act on my part. I also understand that as part of the application process, my child's criminal history and DMV record will be checked by the Edinburg Police Department.

  • 6. APPROVAL: I have read and understand the participation approvals and agreements and by my signature agree to its terms.

  • Date:*
     - -
  • Date:*
     - -

  • PARTICIPANT RULES

  • PLEASE READ CAREFULLY

  • 1. Each participant must complete an application and have a parent/guardian sign the parental permission authorization below.

  • 2. Except for sickness, emergencies and pre-approved absences, participants should not be absent from any of the training sessions. Absences from more than two sessions may prevent a participant from graduating.

  • 3. Participants are expected to dress in appropriate attire. No shorts or tank tops are permitted. Jeans are permitted as long as they are clean, have no holes, cuts, etc. Only the fire department academy shirt is permitted. The instructors reserve the right to request the student leave the classroom. The student may change and return that day if possible.

  • 4. Participants shall not be armed at any time during the academy. This includes pepper spray, handguns, knives, pocket knives, any item which can be constructed as a weapon. Any violation of this rule could result in immediate dismissal from the academy.

  • 5. Participants shall be polite and respectful of all instructors, firefighters, other adults and students during class.

  • 6. It is important that class start on time and there are as few disruptions as possible. Participants are expected to arrive on time.

  • 7. Gang symbols, paraphernalia (such as bandanas, beads, etc.) will not be tolerated. Displaying gang signs ok symbols will result in the student being asked to immediately leave the program.

  • I certify that I understand the requirements of participating in this program.

  • Date*
     - -
  • Date*
     - -

  • ESSAY

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Date:*
     - -

  • RECOMMENDATION

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Date:*
     - -

  • Counselor/Teacher/SRO/Adult over 21 (that is not a family member):

  • Format: (000) 000-0000.
  •  
  • Should be Empty: