Fitness Mentoring Program Legal Waiver Form printable pdf download

Fitness Mentoring Program Legal Waiver Form

FITNESS MENTORING PROGRAM LEGAL WAIVER FORM

I, _____________________________, (Print name) execute this Waiver and

Release in favor of the City of Dallas, and its departments, officers, employees, agents,

assigns and insurers (herein called “the City”).

I, the undersigned, hereby request permission to participate in the candidate

physical ability test fitness mentorship program as a part of my application for

employment as a fire fighter for the City of Dallas. I am fully aware of the risks and

dangers involved, and that unanticipated and unexpected dangers may arise during such

activities and I agree to assume all risks of injury to my person and property that may be

sustained in connection with participating in said program.

In consideration for being permitted to participate in the Fitness Mentoring

Program for the test, I, myself, my heirs, legal representatives and assigns, release and

hold harmless the City from all claims, demands and causes of action for all damage,

bodily injury or liability of any kind that might accrue to me or arise out of these

activities. I hereby agree not to bring suit or other legal action, either State or Federal,

based upon any claims against the City arising directly or indirectly from my

participation in the Fitness Mentoring Program.

By signing below, I acknowledge that I have read and fully understand the terms

of this Release and that I have received and read a copy of the CPAT Candidate

Preparation Guide and the CPAT Orientation Guide. My agreement to this release,

attendance and participation at mentorship sessions is voluntary and I am not in any way

employed by or an agent of the City of Dallas.

Signature: _____________________________

Notary:_______________________

Printed Name:__________________________

Date:_________________________

Address:______________________________

Commission Expiration:__________

______________________________

[Notary Seal]

Fitness Mentoring Program Legal Waiver Form