PUBLIC SAFETY ALLIANCE REGISTRATION FORM FOR:
CONTROLLED DELIVERIES
Monday, May 13, 2019
0800 - 1600
Location: S.O.G. Training Center
Directions: 15820 Whittier Blvd., Whittier, CA 90603

A LIMITED PRESENTATION EVENT YOU CAN'T MISS!


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Prerequisite: Students must be full-time, commissioned peace officers, reserve, or act under the umbrella of a law enforcement agency.

Course Description: This one-day course provides field Officers, Agents, and Supervisors the necessary tools to safely and successfully conduct controlled deliveries of drugs, currency and other contraband. Learn what is important for you now, that will affect others in the future. Modules include: Risk Reduction, Decision Making Process, Countering the Counter, and much more. At the end, students will demonstrate their knowledge during a table top exercise. Protect yourselves and your agency; learn these techniques.

Who Should Attend: Patrol Officers, Detectives, Agents, Auto theft

Dress Code: Uniform, business casual, or the uniform of the day

Lodging and Meals: Students are responsible for their own hotel and meals.

Contacts: If you are running late to the course or have other problems or questions regarding this course, please contact:
Program Manager, Nick Ramos at nickramos@trainPSA.org or (505) 573-9672.
Office, at info@trainPSA.org


APPLICANT INFORMATION *required 
Name will appear on certificate of completion
First Name: 
*

Last Name: *

Position/Title/Rank: *

Agency/Organization Name: *

State (2 characters e.g. TX): *

COMMENTS
Provide any specific information regarding registration
 

 

CONTACT INFORMATION
(for registration purposes only)
Phone Work: (include area code) *

Mobile Phone: (include area code)

E-mail: *

Alternate E-mail Address:

TRAINING COORDINATOR / SUPERVISOR
Full Name

Phone:  (e.g. ###-###-#### - ext) 

Training Coordinator Email Address: (if applicable)
(Will receive copy of confirmation)

AFFILIATION INFORMATION*
Active STC Members may attend this course and full contractual obligations
apply with PSA.  Certified STC Agency Info must be provided.


 I am not a STC Member - $135

 I am an active STC Member
        Certified STC Agency: 
      Note: All STC associations will be confirmed prior to
      the event.

TOTAL COST

 


Method of Payment:
 Check / Pay at Door    Credit Card

Credit Card Information (all fields required)
Card Type

Cardholder's First Name

Cardholder's Last Name

Credit Card Number

Exp Date
(e.g.: 05/2020)
Security Code

 

Cardholder's Billing Street Address

Billing City

Billing State
(2-digit state code)
Billing Zip Code

Billing Country
(2-digit country code)
I AGREE TO THE FOLLOWING HOLD HARMLESS RELEASE AGREEMENT

I know that participation in some of the Public Safety Alliance projects can be potentially hazardous and I agree that my participation in this activity is entirely voluntary. I know I should not enter this activity unless I am medically able to participate and completing this PSA process attests that I am medically fit to participate.

  1. I fully recognize and appreciate the dangers and hazards inherent in the activity, which I have had a full opportunity to investigate through any questions I wished to ask of the responsible person(s). I agree to assume all the risks and responsibilities arising out of my participation in the activity and any other activities undertaken as an adjunct thereto.
  2. That in consideration of my participation in this activity, I hereby waive, release and forever discharge and agree to indemnify and hold harmless Public Safety Alliance and its trustees, officers, employees and agents, of and from any and all action, causes of action, suits, damages, claims and demands whatsoever, which the undersigned, may not have or may acquire arising from or in any way relating to the undersigned’s participation in the aforementioned event/activity.
  3. I recognize and understand that Public Safety Alliance does not provide any Accident or Medical Insurance.
  4. I have obtained the age of 18 and am legally competent to understand this document and agree to this release as my own free act.
  5. I hereby consent to any publicity, including the use of my name and likeness, in connection with my participation in this activity for Public Safety Alliance publications.
  6. I understand that Public Safety Alliance reserves the right to cancel or reschedule the course with no prior notification to students. Submitted registrations will be returned to the payee in full.
  7.  I have read and understand the terms of this Release and agree to all terms and conditions. 
Your email provider MAY block any sender who is not in your address book/contact list. In order to ensure you receive your certificates, course materiel and course notifications add these addresses BEFORE registering: NickRamos@trainPSA.org; Info@trainPSA.org; Training@trainPSA.org