Bark River Emergency Services and Lisbon Fire Department Hosting

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Bark River Emergency Services and Lisbon Fire Department Hosting 2 nd Annual S.A.F.E.ty Dayz Motor vehicle crashes continue to be one of the leading causes of death and disability in America. In 2016, over 37,000 lives were lost on our roadways. Surviving a motor vehicle crash is dependent on the severity of the crash and the injuries incurred, but it is also linked to the response times of skilled rescue teams and a well coordinated trauma care system. Since 1984, auto extrication learning symposiums have been held throughout the United States, Canada, and many other parts of the world. Vehicle extrication and learning symposiums serve as a catalyst for sharing, learning and exchanging knowledge among participants; thus providing motivation and a wealth of information to further the proficiency of rescuers ultimately saving more lives! Teams participate in both Unlimited Pit and Mutual Aid Pit. Each scenario is set up with vehicles systematically crushed to create actual damage while impinging rescue manikins (no two scenarios are the same). Teams are then summoned to the pit to perform a vehicle extrication rescue. Team performances are critiqued by a team of experienced rescuers/evaluators using specific performance criteria. Bark River Emergency Services has limited this challenge to ten teams and the registration fee is $100 per team. Registration forms can be obtained by contacting Dave Dean, Fire Chief, Hartland FD, at 262-367-6878. The deadline date for registration is May 2, 2018, and is on a first-come, first-serve basis. A team meeting and learning symposium will be held Friday evening, June 1, 2018. Extrication tools and equipment will be provided. After teams have participated in this event, the registration fee will be refunded to the applicable department.

TENTATIVE SCHEDULE Friday, June 1, 2018: 6:00 pm Introductions/Team Meeting Saturday, : 7:00 am Extrication tools and equipment set-up 8:00 am Set-up for vendors, organizations, sponsors, etc. 9:00 am S.A.F.E.ty Dayz begins NOTE: Throughout the day, there will be demonstrations, exhibits, etc. Further scheduling TBD/forthcoming.

S.A.F.E.ty Dayz Information/Assistance Available... Vehicle extrication is the most important life-saving rescue operation. Some fire chiefs or training officers look to create or find more vehicle rescue training opportunities to help their rescuers keep pace with the rapid changes and improvements in vehicle safety and design. Fire Chief Doug Brahm, Town of Lisbon Fire & Rescue, hosts the Bark River Emergency Services; S.A.F.E.ty Days which focuses on transportation related issues, i.e. prevention, safety and extrication, etc. This is one of those unique opportunities to help prepare newly appointed firefighters to function as productive extrication team members when called to a vehicle crash involving vehicle entrapment. S.A.F.E.ty Dayz serves as a catalyst for sharing, learning, sharpening and exchanging knowledge among participant; thus challenging, motivating, and furthering proficiency of rescuers extrication knowledge and skills. If your department is interested in participating or have questions regarding S.A.F.E.ty Days, the Hartland Extrication Team is offering their experience and full assistance with interested teams. For further information contact Fire Chief Dave Dean at (262) 367-6878.

SAFETY GUIDELINES SAFETY OFFICER: 1. The Safety Officer will have the authority to stop any evolution, when in his/her judgement, there exists a potential danger to spectators, set-up crew, team members, etc. 2. The responsibility of the Safety Officer is to prevent injury through unsafe acts or hazardous conditions and work in conjunction with the Head Judge/Evaluator and the authority having jurisdiction (AHJ). 3. The Team Captain is responsible for presenting home-made or unapproved tools or apparatus to the Safety Officer for inspection prior to performing in the challenge/learning symposium. PERSONAL PROTECTIVE EQUIPMENT: 1. The minimum requirement for the participants working in the action circle area will be as follows: approved head/eye/hand/footwear protection. Exposed skin from neck to toes should be covered at all times. 2. The minimum requirements for the judges/evaluators, safety officers, camera crews and tool/equipment suppliers in the action circle area will be as follows: approved head protection, safety glasses and safety foot wear. Scenario set-up crews must wear hand/eye protection while working in the action circle area. 3. No Smoking in the action circle or vehicle preparation area. 4. Action circle and vehicle preparation areas are out of bounds to all spectators unless accompanied by a safety officer and properly protected. 5. FREEZE command by a judge/evaluators, safety officers or team members will alert the team of an unsafe condition. The hand will be raised by the official giving the FREEZE command and will stop the evolution and time immediately. The FREEZE command by an extrication team member will not stop the clock. The unsafe condition will be identified and verified that the I.C. understands the problem which must be corrected prior to starting the clock again. 6. All tools and equipment will be maintained in a safe operating condition. Defective tools and equipment will be removed from service immediately. 7. Workman s Compensation coverage is the responsibility of the participating fire department/ local municipality. All personal injuries should be treated and reported to the AHJ immediately. 8. Failure to observe the Safety Guidelines could result in the team s disqualification. 9. All fuel tanks will be removed from the vehicles and all fluids will be drained before a vehicle enters the action circle area. 10. There may be alcohol on the premises. Any evidence of drug or alcohol consumption prior to or during the team s scenario will be grounds for immediate dismissal from the challenge/learning symposium. *** BE SAFE ***

RELEASE OF LIABILITY 1. The undersigned (department name) has requested to participate in the S.A.F.E.ty Dayz hosted by the Bark River Emergency Services: For and in consideration of the organizations agreement to grant this request, the undersigned and all successors, assigned heirs, executors, and administrators (hereinafter referred to as the undersigned ) understand and agree to the following: 2. I, the undersigned understand and agree that participation in S.A.F.E.ty Dayz shall be at the undersigned s sole risk, and that the Bark River Emergency Services and SAFE, its elected and appointed boards, agents, servants, employees, and officers shall not be liable for any physical injuries or any damage to the undersigned, or for damage to the undersigned, or for damage or loss of property of the undersigned, whether caused by negligence or other acts or omissions of the organization, other than liability for intentional or grossly negligent acts. By assumption of all risks, the undersigned agrees that the Bark River Emergency Services and SAFE shall not be liable for any claim, action, cause of action, damages, or demand, in law or equity, of every kind or character, on account of personal injury or damage to the undersigned or the undersigned s property. 3. I, the undersigned acknowledge that this agreement constitutes the entire understanding and agreement concerning liability for the event set forth in the above paragraphs, and the undersigned acknowledges that this agreement cannot be changed without a writing signed by the authorized agent of the Bark River Emergency Services. 4. I, the undersigned acknowledge that during this learning symposium/challenge, physical exertion is required and I realize that an accident may occur during this event which could cause me injury (such as slipping/falling, falling objects, etc.). I realize that it is possible that I could become sick or ill during the learning symposium (heart attack, respiratory problems, etc.). Acceptance of enrollment in this event constitutes an agreement to conditions stated. Any injury or medical problems that should occur will be referred to the named department s workman comp claim department. I HAVE CAREFULLY READ AND UNDERSTAND THE FOREGOING AGREEMENT AND AGREE TO THE TERMS AND CONDITIONS. Name of Department: Date: Fire Chief: (Printed Name) (Signature) Print Name: Team Members Signature: 1. 2. 3. 4. 5. 6. 7. 8.

Team Registration Name of Team/Department: Address: City: State: Zip Code: Contact Name: Phone #: Email: Hydraulic tool manufacturer preference (TNT, Hurst, Amkus, etc.): Team Members: 1. 5. 2. 6. 3. 7. 4. 8. (alternate) All team registrations must be accompanied with: Team Release and Liability Form Team Picture Entry Fee ($100) Please make checks payable to: Mail to: Bark River Emergency Services Hartland Fire Department 150 Lawn Street Hartland, WI 53029 Note: All forms and payment must be received by May 2, 2018. For additional information, please contact Fire Chief Dave Dean, Hartland FD at (262) 367-6878 or Fire Chief Doug Brahm, Town of Lisbon FD at (414) 507-4491.

Hotel Accommodations Best Western Waukesha Grand 2840 N. Grandview Boulevard Pewaukee, WI Rooms have been blocked until 4/30/18 for the nights of 6/1/18 and 6/2/18. Event room rates starting at $80.00. When calling to make your reservation, inform the hotel that you are participating in the S.A.F.E.ty Dayz extrication event. Any questions or concerns, please contact Fire Chief Dave Dean, Hartland FD, at (262) 367-6878.

S.A.F.E.ty Dayz Vehicle Extrication Challenge Sponsor Form Name of Business: Address: City, State Zip Business Contact Name: Phone Number: Business Contact Email Address: Sponsorship Level (Circle One): Platinum Gold Silver Bronze Contributor Door Prize/Handouts Event Contacts: Doug Brahm, Fire Chief, Town of Lisbon, at 414-507-4491, or John Olshanski, Executive Director, Safe And Fast Extrication at 414-526-3113. Levels of Sponsorship: Door Prize/Handouts Donation Please list any item(s) you would like to donate as door prizes or hand out items. Your company name will be displayed on the table with the prizes and the name of the company will be announced as the sponsor of that door prize item when it is awarded. Contributor (Under $100) Donation in the amount of $. The name of the individual or company will be displayed on a banner at this event. Check box if you want to remain anonymous. Bronze Sponsor ($100) = The name of the company will be listed on the Bark River and SAFE websites prior to the show and placed on the banners at the show. We will disperse sponsor coupons, flyers, or business cards at team registration. If a sponsor wishes to have promotional items dispersed at the event, they need to drop these items off at the Lisbon Fire Department no later than 4/15/18. Silver Sponsor ($250) = You will receive everything that the Bronze Sponsors receive, plus the following: The announcer of the extrication event will name your company throughout the event and we will put up two of your business own banners. You will receive one free 10 x 20 vendor area. Gold Sponsor ($500) = You will receive everything that the Silver Sponsors receive, plus the following: The company s name will be placed on banners within the park and around the event. We will provide you with a plaque to hang in your business, listing you as a Major Sponsor. Platinum Sponsor ($1,000) = Everything that the Gold Sponsors receive, plus the following: The company s name will be placed on the banners in the largest writing above the Gold Sponsors. In addition, company name will be placed on the boom of the crane setting up crash scenarios (only 2 spots available-first come/first serve). ***All Gold & Platinum Sponsors will be listed on large displays at the event as Major Sponsors. ***Please make checks payable to the Lisbon Firefighters Incorporated and either give it to your event contact person, or mail Sponsorship and pre-registration forms to: Lisbon Fire Department c/o SAFE Challenge N54 W26455 Lisbon Rd. Pewaukee, WI 53072 ***In order to guarantee that you will receive all items listed above, please have all forms and monies sent in prior to 4/03/18. For questions, please contact Chief Doug Brahm at (414) 507-4491