Kids Fire & Life Safety Education Program Request

Anchorage Middletown Fire & EMS

Kids Fire & Life Safety Education Program Request
Fire & Life Safety Education for Kids
Kids Fire & Life Safety Educatation Program presentation will educate children ages 3 to 18 on Fire and Life Safety issues such as:

Smoke & CO Alarms

Stop-Drop & Roll

Pool Safety

Bike Safety

Gun Safety

Injury Prevention

EDITH (Exit Drills in the Home)

A member of the Anchorage Middletown Fire & EMS Community Risk Reduction Division will teach this program either at one of our facilities or at an event, meeting or school at a location within our protection area that you choose.
Kids Fire & Life Safety Programs come in many forms, please choose from the list below:

School or Daycare VisitChilds Birthday Party (2 to 4 hour event).Fire Station Visit (during school hours or at other times)Scout Fire Safety BadgeCommunity EventOther, please put details in comments section below:
Please provide the type of Kids Fire & Life Safety Program you are looking for if it is not listed above or other information you feel may be helpful:
Name of Contact*

PrefixFirst NameLast NameSuffix
Contact Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Email:
example@example.com
Contact Phone Number*

Area CodePhone Number
Location for A Kids Fire & Life Safety Education Program - if not at one of our firehouses.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please choose one of these two stations that can accommodate a child's birthday party?*

Station 32 - Douglas Hills / Hurstbourne Lane area - 10217 Shelbyville Road - 40223Station 38 - Norton Commons / Prospect - 9514 Featherbell Blvd. - 40059
If you wish to have your education conducted at a fire house or this is a Fire Station Visit Request, please choose which station?*

Station 31 - Middletown Area - 108 Urton Lane - 40223Station 32 - Douglas Hills / Hurstbourne Lane area - 10217 Shelbyville Road - 40223Station 33 - LaGrange Road - I-265 Area - 13012 Factory Lane - 40245Station 34 - Anchorage Area - 1400 Evergreen Road - 40223Station 35 - Eastwood Area - 16010 Shelbyville Road - 40245Station 36 - Fisherville Area - 15000 Taylorsville Road - 40223Station 37 - Brownsboro Area - 8412 Brownsboro Road - 40241Station 38 - Norton Commons Area - 9514 Featherbell Blvd. 40059Station 39 - Worthington Hills / Fincastle Area - 4700 Murphy Lane - 40241Station 40 - Prospect Area - 8905 U.S. Highway 42 - 40059Station 41 - Glenview / Riverwood Area - 4400 Brownsboro Road - 40207 (St.MFD#2)
If there are specific goals you would like to acheive from this education, please select below:

Scout Fire Safety BadgeFire & Life Safety Education (age appropriate)Fire Station Visit
Please tell us the age groups of the attendees, you may check more than one.*

2 to 56 t0 1011to 1314 to 1818 to 3030 to 50Older than 50
Please provide an approximate number of kids ages 2-5 who will attend.*
Please provide an approximate number of kids ages 6-10 who will attend.*
Please provide an approximate number of kids 11- 18 who will attend.*
Day(s) and Time(s) for Event or Visit

Even if you only need one day and time frame, please choose at least three options in the order of preference. Options could be the same date with different times but keep in mind some dates may not be available. If applicable, please choose a start and desired end time:
Desired Date Option 1*

MonthDayYear
Date
Desired Start and End Time Option 1

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Desired Date Option 2

MonthDayYear
Date
Desired Start and End Time Option 2

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Desired Date Option 3

MonthDayYear
Date
Desired Start and End Time Option 3

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Please provide any notes, comments or other information you feel may be helpful:
A member of the Anchorage Middletown Fire & EMS Community Risk Reduction Division will contact you to discuss your need and the availability of dates and locations. In most cases this will happen within 3-4 business days at most.

The Anchorage Middletown Fire & EMS Community Risk Reduction Division is open 7am to 5pm, Monday throught Thursday.

If your reqeuest for dates is less than 30 days in advance, we cannot gaurantee that your dates will be available. Emergency Incidents may also hamper access for your event.
Should be Empty:

Anchorage Middletown Fire & EMS

Fire & Life Safety Education for Kids

Day(s) and Time(s) for Event or Visit