nsw security industry instructor course baton handcuffs training senior first aid enrolment form

Subject: Enrolment Kit for the Defensive Tactics Baton and Handcuffs

Dear Instructor Candidate,

Thank you for choosing Safecity as your Course Provider. I have detailed below the course information you require. Costs of all the courses are on page two of the application form.

The next NSW Defensive Tactics Baton and Handcuffs will be held in Sydney and will be conducted over 9 weekends.

When we receive your application and fee, we will send you the Instructor Course Manual.

Cost includes: Course manual, Software, Tuition, Certificate IV in Assessment and Workplace Training, The Defensive Tactics Baton and Handcuffs Instructor modules, and the Course in Employ Baton and Handcuffs Manuals.

Course requirements:

You should be proficient with the use of weaponless techniques, batons and handcuffs. (A background in self-defence or martial arts which deal with holds and grips is not necessary but is recommended.)

Please bring the following equipment to the course:

Long baton and expandable baton
Duty belt complete with keepers, expandable baton pouch and long baton ring
Uniform, overalls and/or other appropriate apparel. Please note gym wear and other sporting apparel is not permitted. All training will be conducted in uniform.
Notepad, pen and writing material

All the above items are available from Safecity at nominal prices for candidate instructors. Safecity Instructors use the Safecity Expandable Baton a quality three piece 21" expandable baton.

I look forward working with you in this exciting project.

Regards,

Alexander Wilon JP PhD
Managing Director

Training Aids and First Aid Certification

Course participants use a fully illustrated manual with step-by-step photographs and diagrams. The student manual mirrors the instructor manual.

The course also makes use of Safecity's Quiz Wizard software which I designed to help trainees with their studies.

This is the only Australian Defensive Tactics Baton and Handcuffs course to offer Senior First Aid certification. In the event of an injury, the Instructor is able to offer immediate care which may save lives.

You will learn and practise teaching skills specifically designed for defensive tactics instructors. You will plan, rehearse and practise the full program that you will be teaching your future students. If you apply yourself and cooperate with your course providers, I guarantee you will be ready to teach a high quality defensive tactics baton and handcuffs accreditation course.

If, through no fault of your own, you are unable to successfully complete the practical component of the course, I will enrol you in the subsequent course free of charge. This offer obviously does not apply if you do not cooperate, choose not to study the course material.

Most importantly, I promise that you will be learning in a dignified and supportive environment. Your course providers are not only the best qualified instructors for this project--they are also helpful and friendly people, genuinely interested in your success. You will soon discover that there is no room in our classes for outbursts of egos or for negative and disparaging remarks.

As a Safecity Graduate Instructor you will become part of our team. We will support you with marketing ideas and other surprises we do not wish to announce just yet.

About Safecity Training Academy

Click here to view our company profile. Please be sure to read our policy against harassment and vilification.

Instructor candidate check list

Application form completed and signed.

Medical Statement completed and signed

Assumption of risk form completed and signed

Payment (cheque or money order)

If claiming exemption from Senior First Aid component include the certificate

Thank you!

LICENCES AND EQUIPMENT CHECK LIST

You will need the following equipment

Duty belt complete with belt keepers
Overalls and/or other appropriate range apparel
Notepad, pen and writing material
Long baton and expandable baton
Duty belt complete with keepers, expandable baton pouch and long baton ring
Safety Equipment: Shin guards
Uniform, overalls and/or other appropriate apparel.
Notepad, pen and writing material

Please remember all practical weaponless techniques, baton and handcuffs training will be conducted in uniform.

Enrolment kit. Please be sure to enclose all of the pages after this line

SAFECITY TRAINING ACADEMY

APPLICATION FORM PART A Preferred First

Name_____________________________Birth date____________ Sex M F

Please write your full name as it appears on your licence.

Full Name ________________________________________________________________

Security Licence #_________________________________ Expiry date_____________

Postal Address _______________________________________________________________

City______________________________________State__________Postal Code________

Residential Address________________________________________________________

City______________________________________State__________Postal Code________

E-mail address__________________________@__________________________________

Contact home phone number ( )_____________________________________________

Contact work phone number ( )_____________________________________________

Contact fax number hm/wk ( )______________________________________________

Occupation__________________________________________________________________

If you have never attended a Safecity course, have you successfully completed a...

•Senior First Aid Certification? ____________ (please attach copy of certificate)

APPLICATION FORM PART B - PERSONAL INFORMATION

Name ___________________________ Surname _______________________________

1. During this course you will participate in role plays which may involve: a. physical exertion. b. body contact with other participants and the lecturers c. some offensive language and simulated threatening behaviour d. the use of weaponless techniques (holds, strikes) and batons and handcuffs

Do you clearly understand the meaning of points 1(abcd)?_______________

2. Do you suffer from any physical or mental disability that may affect your participation in this
course? __________________

3. Are you pregnant or attempting to become pregnant?______________________

4. Have you ever been charged with a criminal offence (other than minor traffic offences) in Australia or overseas?_____________

To the Directors of Safecity Training Academy, I fully understand the meaning of points 1,2,3,4 in this application form. I have answered all questions truthfully to the best of my knowledge.

I should like to enrol in Safecity's ...

Senior First Aid Certificate: $100.00. Necessary if not already qualified Senior First Aid)

Defensive Tactics Baton and Handcuffs $1400

Certificate IV in Assessment and Workplace Training #BSZ40198 (Does not qualify you as a $800

Conducted in ______________________________________________________________

On the __________________________________________________

I have enclosed my cheque/money order for the amount of $____________________ being payment in full for my course fees.

OR I wish to pay $ __________ by credit card.(circle) VISA MASTERCARD BANKCARD

Card Number _________________________________ Expiry ____________________

Name on the card _________________________ Signature _________________________

Upon receipt of my course fees, you will confirm my enrolment and send me the course manuals.

Signature_______________________________ Date______________

MEDICAL STATEMENT PART A Part of your training may involve vigorous physical exercise, and baton and handcuffs instruction. You may be exposed to loud noise. Please read this carefully, complete the form IN CLEAR HANDWRITING STYLE before signing. Please discuss any questions you may have with your Family Doctor. This information will be treated as confidential.

NAME________________________SURNAME_____________________DOB_______

Please answer the following questions on your past or present medical history with a YES or NO, if you are not sure answer YES. Your Doctor will explain the question thoroughly. A YES response to a question does not necessarily disqualify you from the course.

Could you be pregnant or are you attempting to become pregnant? ________

Do you regularly take prescription or other medications? ________

Are you over 45 years of age and one of the following applies: Currently smoke, have a high cholesterol level, have a family history of heart attack? ________

Have you ever had or currently have: Asthma or wheezing with breathing or with exercise?_______

Any form of lung disease? __________

History of chest surgery? __________

Claustrophobia or agoraphobia? __________

Epilepsy seizures, convulsions? __________

History of blackouts or fainting? __________

History of diabetes? __________

History of arm or legs problems? __________

Inability to perform moderate exercise? __________

History of high blood pressure? __________

History of heart problems? __________

History of ear disease or damage to the ear? __________

Have you ever had or do you currently have:

History of bleeding or other blood disorders? ________

History of any type of hernia? ________

History of drug or alcohol abuse? ________

Problems of any type with vision? ________

Are you colour blind? ________

Is there anything else about your health we should know? _______

If you have answered yes to any of the above questions, please provide details.

I hereby certify that the information I have provided about my medical history is accurate to the best of my knowledge.

Signature____________________________________ Date________________________

ACKNOWLEDGEMENT OF ADVICE AND CONFIRMATION OF ASSUMPTION OF RISK Please read this carefully, complete the form IN CLEAR HANDWRITING STYLE and initial each paragraph before signing. This form must be signed before a witness over the age of 18.

I (Name and Surname)_____________________________________,

(date of birth) _____/____/______

of (residential address)_________________________________________________________

in the State of______________ do solemnly and sincerely declare as follows:

I hold a __________________________________________licence,

number___________________________________________

The licence is valid until _________________.

There are no restrictions that prevent my use or possession of batons and handcuffs. I acknowledge that I am aware of the inherent risks of undertaking the with Safecity.

In particular, I acknowledge that I have been advised of the following:

That part of my course may involve physical exertion and body contact with my instructors and other trainees.
That part of my training may involve using defensive tactics involving the use of holds and restraints, batons and handcuffs both in good and poor visibility conditions.
That if I am found to be intoxicated during the course I will be dismissed from the course.
I further acknowledge that my attendance to the course is at the discretion of the Course Director and that he or she may dismiss me from the class if my behaviour, attitude or actions are considered dangerous, inappropriate or distracting to other candidates.
I further acknowledge that I am aware of the risks associated with the NSW Certificate IV Workplace Trainer Cat. II Defensive Tactics Baton and Handcuffs Course conducted by Safecity Services Pty. Ltd. and I still wish to undertake the course with Safecity Services Pty. Ltd and its instructors, and hereby release and hold harmless, Safecity Services Pty. Ltd, its proprietors and all persons involved with my training, from any suit, demand or claim arising as a consequence of death or injury received by me during my participation in the said course.
I further acknowledge that this document may be relied upon in any proceedings instituted in any Court by me or my heirs, executors and assigns.

___________________________________           ______________________________
Signature of applicant                                                Signature of witness
                                                                                 _________________________
                                                                                 Name of Witness
______________________                                     _______________________
Date                                                                          Date

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Safecity Training Academy is a division of
Safecity Services Pty Ltd ACN 055 464 581
Master Licence #403546788
Commissioners Permit #407677777
P.O. Box 177 Oberon NSW 2787 AUSTRALIA
Phone 02-63355216 Fax 02-63355229