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The Trenton Fire Department - Fire Explorer Post #207
Youth Program
GUARDIAN CONSENT FORM

Member Information

Full Name:_______________________________ Date of Birth: _________

Address:_________________________________________________

City, State, Zip:____________________________________________

Home Phone:________________________ Cell: ______________________

Male / Female (circle)

I,________________________________________, legal guardian of, ______________________________ do give my permission/consent for my young person to participate in non-operational activities of the Fire Explorer youth program activities sponsored by the Trenton Fire/Rescue Department. My young person has received, understood, and agreed to follow the rules and regulations of the program. I also understand that the membership of my young person may be terminated at any time at the discretion of myself or the department. I give my permission for the advisors to view my young person’s school grades and attendance records.

I,______________________________ a student of _____________________ High School, due to wish to apply for the Fire Explorer youth program membership sponsored by the Trenton Fire/Rescue Department. I have received a copy of the rules and regulations form. By signing below I agree to abide by the rules and regulations as set forth in said forms. I also understand that my performance at and away from the activities of the program will directly reflect on my membership with the program. I am aware that the advisors have the right to obtain and view my grades and attendance records at the school.

_________________________________
Signature of Parent/Guardian     

_________________________________
Signature of Young Person

_________________________________
Signature of Chief

_________________________________
Signature of Advisor

SUBMIT FOR MEMBERSHIP
- Medical Consent / Notification Form filled out and signed
- Copy of most recent grade card. (see grade requirements)
- $25.00 fee.
- 100 word essay “Why I want to be a Fire Explorer” with information about yourself

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BELOW FILLED OUT BY ADVISORS

Application approved / denied on ________________
(circle one)
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