West Bountiful City Police Department

Release and Waiver Agreement

This release and waiver agreement constitutes a binding agreement between West Bountiful City and the undersigned. It is intended to
release and waive any claim against the City for injury or loss, even if such injury or loss is caused by the passive or active negligence of an
employee or agent of the City.
1.

I, _____________________________________, on behalf of, _______________________________not being a member of the West

Bountiful City Police Department, have made a voluntary request for permission to ride as a passenger in a West Bountiful City Police
vehicle on ___________________, 20__, while the vehicle is being operated by a member of the West Bountiful City Police
Department, engaged in the performance of his or her duties as a police officer which include the activity of Pokemon Go. The above
signed will accompany a West Bountiful police officer around West Bountiful City on foot and vehicle.

2.

I agree that I, and not the West Bountiful City Police Department, initiated the request for permission to ride in the West Bountiful City
Police vehicle and that permission for me to do so is granted expressly and conditionally upon my execution of this release and waiver
agreement.

3.

I understand the risks and dangers, which may result in property damage, personal injury, and even death. I expressly and voluntarily
assume all risk of death, personal injury, and property damage sustained while I am riding in a West Bountiful City Police vehicle,
including risks arising from the passive or active negligence of City employees and/or agents or hidden, latent or obvious defects in
the facilities and/or vehicles used.

4.

I hereby forever release and discharge the West Bountiful City Police Department, its members, West Bountiful City, and employees
and officers of West Bountiful City from any and all liabilities, claims, demands or causes of action for injuries or damages arising from
or related to my riding as a passenger in a West Bountiful City Police vehicle including, but not limited to losses; injuries or damages
caused by the passive or active negligence of the City, the West Bountiful City Police Department or any employee, officer or agent of
the City; or hidden, latent or obvious defects in the vehicles used. This release applies to any and all damage or loss to my person or
property.

5.

This agreement applies to all activities associated with my riding in a West Bountiful City Police Department vehicle and activities that I
may witness or be passively involved in as a civilian passenger in the police vehicle. I understand as a ride along participant the use of
any recording device is expressly prohibited. This includes audio and or visual recordings, posts to social media etc. I understand I may
have access to confidential criminal records and or Department of Motor Vehicle record information while participating in the ride
along. This information is controlled by statute. Misuse of such information may adversely affect an individuals civil rights and violates
the law. Violation of this law, by you, as an observer of the procedures of the West Bountiful Police Department, may result in your
being prosecuted in a criminal and/or civil action.

6.

I expressly recognize and affirm that my signature on this release and waiver agreement has the legal effect, forever binding upon
myself, my heirs, successors and assigns, of barring any claim or suit by me or on my behalf, for any injury or loss sustained in
connection with my riding in a West Bountiful City Police vehicle, including for any active or passive negligence of the City or its
employees and/or agents. With this knowledge, I agree to assume any risk of injury or damage and execute this release and waiver
with full understanding of its effects.

7.

I further agree that if I file a claim or suit seeking damages for injury or loss alleged to relate to my riding in a police vehicle, I will be in
violation of this agreement and will be liable for attorneys fees and/or costs incurred by the City in defending such claim or suit.

I have read the above rules/regulations. I understand and agree to abide by them. I also allow the use of photographs taken during the event to
be used on the city website and Facebook page.

Date:

Parent/Guardian Name:
Childs Name:
Signature:
Telephone:
Address: