STATE OF TEXAS
COUNTY OF FORT BEND
RELEASE
Know all men by these presents that I, ________________________________________, of
______________________ County, Texas, in consideration of being allowed to accompany the Stafford
Police Department on official patrols, do by these presents for myself, my heirs, executors,
administrators, and assigns, hereby release and agree not to hold liable, the City of Stafford, its officers,
agents and employees from any and all actions, causes of action, claims, demands, costs or damages
arising from or resulting from property damage, personal injuries or death sustained by me or my
property while accompanying him, her or them.
I further agree by these presents for myself, my heirs, executors, administrators, and assigns, to
indemnity, hold and save harmless the City of Stafford, it’s agents, officers and employees, from any
liability, action, claim, damage, award or judgment incurred or suffered by the city or individuals as a
result of any act or omission by me or caused by me while accompanying any employee, agent or officer
of the city.
In addition, I
make the following representations and acknowledgments upon which I intend the city to
rely: (1) I am of lawful age; (2) I understand and agree that while accompanying any officer, agent, or
employee of the city during his law enforcement rounds, I am to be only an unarmed law observer and
bystander with no active role whatever and that I will have and am given no duties, rights, powers, or
authority whatever other than those conferred by law upon any other person in like or similar
circumstances as may arise from time to time and will under no circumstances interfere with city
officers or offer any advise or counsel to any person being questioned, investigated, taken into custody
or arrested by any city officer; (3) neither will I be considered an agent, servant, or employee of the City
of Stafford, and thus, I will not be covered by the city for any workers’ compensation, death or disability
benefits; (4) I realize that I may and will at unpredictable times be placed in both foreseeable and
unforeseeable positions or considerable danger and agree that neither the city nor any of it’s officers or
employees shall be obligated to take any steps or actions to protect my person or provide a means of
07/16 DH
