Loading...

Proctor Application & Agreement for Rescue Technician Swim Test

Boreal River Rescue

Toll Free (866) 242-9383

info@borealriver.com

This form serves as an application and agreement to become an approved RTST-9 Proctor with Boreal River Rescue. Please complete all required fields.


I, the undersigned, agree to uphold the responsibilities and ethical standards outlined in this agreement. 

Upon submission, Boreal River Rescue approves you as an RTST-9 proctor. If you have any questions, please contact us.

View Rescue Technician Swim Test (RTST-9) Guidelines

Please select who will be participating...
AdultMinor
Continue
First Proctor's Name

First Name*

Middle Name

Last Name*

Phone*
First Proctor's Date of Birth*
First Proctor's Signature*
Parent or Guardian's Email Address

Email*

Confirm Email*
Proctor Eligibility

To act as a proctor for the RTST-9, you must:

·      Be 18 years or older.

·      Hold a current Bronze Cross or NLS certification.

·      Upload a copy of your current Bronze Cross or NLS certification below.

  
Click to customize text box label
Valid file types: JPG, GIF, PNG, and PDF
Proctor Responsibilities

·      Administer the RTST-9 test according to the outlined criteria and scoring system.

·      Ensure accurate timing and evaluation for all stations.

·      Allow coaching, but not provide physical assistance to candidates.

·      Submit test results promptly using the official Google Form.

Do you agree to these responsibilities?*
No
Yes
Test Environment and Safety

·      The test must take place in still water with proper supervision and safety measures.

·      Candidates must wear a properly fitting Type III or Type V PFD at all times during the test.

·      If the water temperature is below 15°C, candidates must wear a wetsuit or drysuit.

Do you agree?*
No
Yes
Agreement to fair & objective evaluation

·      You will objectively evaluate candidates based on the RTST-9 test criteria.

·      You will not alter, falsify, or misrepresent results.

·      You understand that Boreal River Rescue may contact you for verification, though this is uncommon.

Do you agree?*
No
Yes
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!