BECOME A MEMBER

Membership Level*

Would you like to include Insurance for $525

Yes
No

Section 1: Applicant Details

Full Legal Name of Applicant*

(including trade name if any):

Mailing Address*

Street Address Address Line 2 City Province Postal Code

Name of Contact*

First Last

Phone*

Email*

Enter Email Confirm Email

Years as a Licensed Display Assistant:*

Age:*

ERD License #*

Please attach a copy of the FRONT & BACK of your ERD License*

Drop files here or

Max. file size: 256 MB, Max. files: 2.

Are you a Canadian Citizen?*

Do you plan to obtain your Display Supervisor designation?*

Do you have a mentor?*

If no, would you like to have one?*

Have you ever been convicted of a felony?*

Please explain the Felony*

Have you ever been involved in a reportable fireworks incident?*

If yes, please explain*

Years as a Licensed Display Supervisor:*

Section 2: Claims

List any and all incidents, circumstances, acts, allegations, errors, omissions or facts which may result in or give rise to a claim against the Applicant, its subsidiaries, affiliates or predecessors in business? If none, please indicate "non" below.*

In the last five years has any incident, circumstance, claim or complaint result in a fine, penalty, request or demand for action or any warning letter for any federal, provincial or local regulatory agency?*

Please explain:

Section 3: Non-Owned or Hired Automobiles

Estimated annual cost of rented automobiles:*

Type of Vehicle Rented (Van, Pickup, etc)*

How often will each type of vehicle be rented and the average duration of each rental?*

Number of Assistants using their automobiles for work on Applicants displays*

Section 4: Operations, Sales and Revenues

Estimated number of displays and revenue for the next 12 months that include the following:

Number of Shows NOT Requiring Endorsements*

Gross Revenue From These Shows

Revenues for this purposes of this application are considered to be 'the show budget less the reimbursed product costs

Number of Shows Requiring Endorsements*

Gross Revenue From These Shows

Revenues for this purposes of this application are considered to be 'the show budget less the reimbursed product costs

Does the Applicant have any endorsements to their license to utilize shells larger than 155mm/Flying Saucers(UFOs)/Nauticals or perform on floating platforms, rooftops, bridges or flatbeds?*

Does the Applicant perform any work with products that requires endorsements (listed in question above)?*

Does the Applicant perform/supervise indoor displays?*

Does the Applicant perform/supervise any special effects work?*

Does the Applicant perform/supervise work for the military? ie. special effects for training exercises*

Does the Applicant perform/supervise displays outside of Canada?*

Have you been cited by any regulatory agencies for unsafe practices or controls within the past three years?*

Please explain:

Are the imported fireworks used in your displays authorized for use by Canadian Government authorities (ERD)?*

If No: Please explain

Are Fireworks Displays performed in compliance with Explosives Regulatory Division of the Ministry of Natural Resources regulations as outlined in the Display Fireworks Manual and Explosives Regulations, 2013?*

If not, please explain

Will Fire Departments personnel be in attendance for each show?*

If no, please explain

Does the applicant: Agree to hold any dealers, distributors, manufacturers, or suppliers harmless & indemnified against claims/suits brought against them for bodily injury/property damage arising either directly/indirectly from the Applicant's operations (by agreement or contract)?*

Please provide a copy

Max. file size: 256 MB.

Does the applicant: Provide warranty or performance guarantees?*

Please provide a copy

Max. file size: 256 MB.

Does the applicant: Assume liability of others by agreement/contract?*

Please attach a copy of the FRONT & B of your ERD License

Max. file size: 256 MB.

Does the applicant: Comply with Explosives Regulations, 2013, for fireworks storage before and after a display?*

Does the applicant: Comply with Explosives Regulations, 2013, regarding the max amount that can be stored prior to a display*

(125kg or 500 e-matches without written approval)

Does the applicant: Have fireworks transported to your displays? Please explain who transports.*

Does the applicant: Store fireworks at the display site in accordance with Explosives Regulations, 2013, and file a site plan including storage details?*

Does the applicant: Use fire prevention and first aid measures that minimize the possibility of harm to people or property?*

Section 5: Signatures & Payments

The undersigned hereby declares that to the best of my knowledge and belief the above statements and particulars are true in every respect and that I have not withheld, omitted, misstated or misrepresented any material facts. The undersigned acknowledges that the insurer can relay on the information contained in this application and, if this application is accepted, agrees that this will form the basis of the association membership and the insurance contract prepared by the insurer.

Please type your full name*

By typing your full name into this field you are agreeing to the terms outlined above.

Date of application*

Payment Methods:

Please make cheques payable to the Institute of Professional Pyrotechnicians, or E-transfers can be sent to admin@fireworksinstitute.net

Total Amount to be paid: $288.75 + plus applicable sales taxes

Next Steps:

Once your registration and payment have been processed, you will be emailed a login and password for the website. This will unlock the memberships section of the site. Join us and other pyros here for videos, discussions, and events. Enjoy benefits, insurance certificates, the forum, related links, discounts and much more. Please allow up to 5 business days for membership application processing.

Payment Methods:

Please make cheques payable to the Institute of Professional Pyrotechnicians, or E-transfers can be sent to admin@fireworksinstitute.net

Total Amount to be paid: $393.75 + plus applicable sales taxes

Next Steps:

Once your registration and payment have been processed, you will be emailed a login and password for the website. This will unlock the memberships section of the site. Join us and other pyros here for videos, discussions, and events. Enjoy benefits, insurance certificates, the forum, related links, discounts and much more. Please allow up to 5 business days for membership application processing.

Payment Methods:

Please make cheques payable to the Institute of Professional Pyrotechnicians, or E-transfers can be sent to admin@fireworksinstitute.net

Total Amount to be paid: $918.75 + plus applicable sales taxes

Next Steps:

Once your registration and payment have been processed, you will be emailed a login and password for the website. This will unlock the memberships section of the site. Join us and other pyros here for videos, discussions, and events. Enjoy benefits, insurance certificates, the forum, related links, discounts and much more. Please allow up to 5 business days for membership application processing.

Assistant Member

Price:

Supervisor Member (without Insurance)

Price:

Supervisor Member (with Insurance)

Price:

Total

$ 0.00 CAD

+ plus applicable provincial sales taxes

Section 1: Applicant Details

Section 2: Claims

Section 3: Non-Owned or Hired Automobiles

Section 4: Operations, Sales and Revenues

Section 5: Signatures & Payments

Total Amount to be paid: $288.75 + plus applicable sales taxes

Total Amount to be paid: $393.75 + plus applicable sales taxes

Total Amount to be paid: $918.75 + plus applicable sales taxes