MAAC Simulator Request Form
Organization Contact Information
Organization Name
Organization Type Law Enforcement Other
Contact Name
Contact Phone
Contact Email
Date and Time of Requested Use:
Class Type and Size of Class
We will need a VirTra trained Operator* We have a MAAC approved VirTra Operator
*The VirTra Operator will interface with the Department / Agency certified instructor to ensure the appropriate scenarios are provided. The Department / Agency certified instructor are responsible for training and critiquing of the scenario and actions of the students.
Will this class be available to the department making the request only? yes no
If no, please provide other participating departments:
Will this class have any non-law enforcement personnel attending the training? yes no
If yes, please provide names/titles and a simple explanation of reason:
Class Title:
Class Description:
Number of Students (estimate):
Select all simulator scenarios that apply:
Active Shooter Ambushes Animal Control Court / Jail Disturbances Domestic Violence Emotionally Disturbed High Risk Entries Hostage Situations Human Factors Off Duty Skill Drills Suicidal Subjects Suspect Contacts Suspicious Subjects Traffic Stops Low Light
Notes / Comments:
Indicate what other training areas are being requested
Click here to view photos and descriptions of all areas (new window)
Select all that apply
Indoor Areas:
Classroom 1 (45 Seats) Classroom 2 (45 Seats) Classroom 1 & 2 (90 Seats) Classroom 3 Conference Room Indoor Practical Area (East End - Apparatus Area) Indoor Practical Area (West End - Ladder / Rescue Props)
Outdoor Areas:
One Story Structure Two Story Structure Four Story Structure & Tower Burn Building - Live Fire* Flashover Unit - Live Fire* Propane Pad - Live Fire* Fire Extinguisher Pad Drafting Pond Pads Extrication Pad Confined Space Props Hazmat Area Forcible Entry Pad Ventilation Ground Level Props K9 Training Area Tactical Building * Live Fire props will follow the required MAAC NFPA 1403 Burn Plan.
Equipment Needs
Indicate the equipment needed. If none required indicate none.
Proof of Insurance must be submitted within two weeks of this training request. The insurance required consists of: a) Statutory worker's compensation and employer's liability insurance; b) Comprehensive, all risks, general liability insurance including personal injury and property damage liability of not less than $1,000.000.00 each occurrence/$1,000,000.00 annual aggregate; and c) Automobile bodily injury and property damage liability insurance with a limit of not less than $1,000.000.00 combined single limit. Upon approval of the application by the MAAC, the applicant agrees to abide by all Rules and Regulations of the MAAC Emergency Services Training Center.
The Applicant agrees to indemnify and hold harmless the MAAC and its employees and agents from any and all claims for any type of personal injury, property or other damages, including attorney’s fees and costs arising out of the execution of this contract or the Applicant's use or occupancy of the premises controlled by the MAAC Emergency Services Training Center. The Applicant acknowledges its responsibility to ensure the safety of its equipment and that its personnel or members are physically able and have satisfied any conditions necessary to participate in the training exercises at the MAAC.
Lead Instructor and/or Senior Officer Understanding: It is your responsibility to insure the safety of the students and the care of this facility. It is mandatory that all personnel participating in training wear complete personal protective equipment that meets current minimum recognized standards for the training being offered. Any recognized damages or broken equipment must be reported to the MAAC immediately. Failure to follow the above requirements may result in your ability or your departments ability to utilize the facility being rescinded.
Individual Waiver and Release from Liability and Indemnity Agreement: Any individual attending a class requiring personal protective equipment must sign a waiver prior to the beginning of class. A copy of the waiver can be filled out in advance of the class or at the beginning of class. GET WAIVERS
