COVENANT NOT TO SUE, PROMISE TO RELEASE, AND RELEASE

In consideration of permission which I have received to accompany one or more Police Officers of the Dacono Police Department, of the City of Dacono, Colorado, a Municipal corporation, in the course of their duty, I,  the undersigned,  do,  by these presents,  release the City of Dacono,  It’s Police Officers,  and public officials from all liability in any causes of action which I may hereafter have on account of any and all injuries and damage to me or my property, on or account my death, arising out of or related to any happening or occurrence while I am accompanying any Police Officer of the Dacono Police Department on duty,  or incidental thereto,  and for the same consideration,  I promise to release and covenant not to sue the said City and the said persons,  and agree to forever hold then and each of them harmless from any such liability,  claims,  demands,  actions,  or causes of action.

The terms hereof shall be in full force and effect on the date hereof and on any other occasion when I may hereafter accompany any Dacono Police Department Officer.

I am aware of the risks and hazards inherent in accompanying one or more Police Department Officers when on duty,  and do hereby voluntarily assume all risk of loss,  damage,  or injury to me or my property,  including death,  which may be sustained while or incidental to accompanying one or more Dacono Police Department Police Officers while on duty.

This release and agreement shall be binding upon,  and my heirs,  executors,  administrators,  personal representatives and assigns,  and shall inure to the benefit of the said City,  Officers and Agents,  Public officials and persons herein designated,  and their heirs,  executors,  administrators,  personal representatives,  assigns and successors in office.


Dated this  _____________________  day of ________________________________, 20______


_______________________________                   _______________________               ____ ________
Signature                                                                  Date of Birth                                       Age


_____________________________________________            _____________________________________
Signature of Parent / Guardian (if under 18)                               Address


_____________________________________________            (____)________________________________
City, State, and Zip Code                                                              Home Phone Number


(____)____________________________                             _______________________________________
Work Phone Number                                                              Requested Date  and time of Ride-Along


Approved?         Yes________              No_________


__________________________________________
Supervisor