RELEASE AND WAIVER OF LIABILITY FORM
For and in consideration of the City of Woodstock Police Department extending
to me at my request the opportunity of participating in the Citizen Ride Along
Program, I hereby assume all risk of personal injury, death, property damage and
any other loss I may sustain in and about any patrol car and in any other way
arising out of the Program. In addition, I hereby release the City of Woodstock,
its Officials, Police Department, Police Officers and all other personnel from any
and all liability whatsoever for personal injury, death, property damage and any
other loss I may sustain in and about any patrol car and in any other way arising
out of the Program.
I further agree to indemnify and hold harmless the City of Woodstock, its
Officials, Police Department, Police Officers and all other personnel from any and
all claims, demands or actions arising out of personal injury, death, property
damage or other loss to me in and about any patrol car and in any way arising
out of the Program.
It is my intent that the assumption of risk, release and hold harmless herein
described are binding upon my heirs, executors and administrators.
________________________ __________________________
Signature of Participant Signature of Witness
________________________ __________________________
Name Printed Name Printed
________________________
Street Address
________________________
City, State, Zip Code
________________________ ________________________
Date of Birth Telephone Number
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