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SIRIUS K9 ACADEMY
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Last modified
5/23/2012 2:00:37 PM
Creation date
5/23/2012 2:00:35 PM
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Contracts
Company Name
SIRIUS K9 ACADEMY
Contract #
N-2012-052
Agency
POLICE
Expiration Date
12/22/2012
Insurance Exp Date
2/16/2013
Destruction Year
2017
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WAIVER AND RELEASE OF LIABILITY FORM <br />To the extent permitted by law, (?}'Qp]?y,J[- ?A'Z,i?y??i? hereby agrees to <br />RELEASE, NAIVE, DISCHARGE, AND HOLD HARMLESS the City of Santa Ana, its <br />officers, employees, agents and assigns (hereinafter collectively referred to as the "City") from <br />any and all claims, demands, damages, rights of action, or cause of action, present or future, <br />whether the same be known, anticipated, or unanticipated, resulting from or arising from his/her <br />voluntary participation in the SIRIUS K9 Academy training program ("Program") andlor his/her <br />presence on or around City property. <br />The above named person shall enter and occupy the Property entirely at his/her own cost, <br />risk and expense, and further acknowledges and understands that the Program is not <br />maintained, operated, or sponsored by the City and that SIRIUS K9 Academy is in no way <br />acting as an employee, agent or representative of the City of Santa Ana in conducting its <br />Program_ <br />IN WITNESS WHEREOF, the party named above has voluntarily and knowingly executed <br />this Waiver and Release of Liability Form as of the date and year written below. <br />Participant: <br />Date: OS-[tl I:Z <br />L?/?Rol??Jt= l'?F?u?!'7HnJ <br />Name: <br />Address: !('o ?,x 7s? <br />Guardian, if Participant is a Minor <br />Name: <br />Address: <br />Relationship to Minor: <br />?_.?> <br />Page 6 of 6
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