Participant Agreement & Waiver
I, _______________________________________, do hereby agree with the below
stated stipulations as part of my participation in this program with the Evans Police
______ I understand and acknowledge that my participation in the Citizens Police
Academy is strictly voluntary on my part. Furthermore, I acknowledge that I am not
entitled to any benefits to include salary, health insurance, etc.
______ I understand I will be participating in activities that may be of a physical nature. I
agree to assume the risk of personal injury, loss of damage, which may result from any
situation to which I am exposed. I agree to act as my own insurer against all hazards and
acts of any negligent person, understanding that my personal insurance may not cover
the activities contemplated by this waiver. I agree to hold harmless and indemnify the
City of Evans, the Evans Police Department, their officers, agents, and employees from
any liability in any cause of action in law or equity which may be asserted against them
for any act or omission arising out of my participation in the Citizens Police Academy.
______I hereby release the City of Evans, the Evans Police Department, their officers,
agents and employees from liability for: (1) any personal injury which may occur; (2) any
damage to my clothing or personal property; or (3) any other loss or damage which may
occur, which results from the acts or omissions of any person including negligent acts or
omissions. Any person includes, but is not limited to myself, all employees of the City of
Evans including Evans Police officers, and persons with whom Evans Police officers or
other employees of the City of Evans have contact. I intend this release of liability to
cover all situations; which may occur during my participation in the program.
______ I understand I may be exposed to information of a sensitive nature and I agree
not to discuss any of that information with others, nor will I bring children to any of the
______ I understand that my participation in the Citizens Police Academy does not qualify
me to become a police officer and at no time am I to represent myself as an Evans Police
Officer, nor will I use my position in this academy to influence others outside the academy.
______ I understand my participation in the Citizens Police Academy is voluntary and I
may be asked to leave the Academy at any time for inappropriate conduct.
Community Outreach & Police Services Unit
Office: 970-475-2266 or e-mail: firstname.lastname@example.org