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<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><b style=3D=
'mso-bidi-font-weight:
normal'><span style=3D'font-size:14.0pt'><o:p>&nbsp;</o:p></span></b></p>

<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><b style=3D=
'mso-bidi-font-weight:
normal'><span style=3D'font-size:14.0pt'>Fort Oglethorpe Police Department<=
o:p></o:p></span></b></p>

<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><st1:place =
w:st=3D"on"><st1:PlaceName
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ize:14.0pt'>Citizens</span></b></st1:PlaceName><b
 style=3D'mso-bidi-font-weight:normal'><span style=3D'font-size:14.0pt'> <s=
t1:PlaceName
 w:st=3D"on">Police</st1:PlaceName> <st1:PlaceType w:st=3D"on">Academy</st1=
:PlaceType></span></b></st1:place><b
style=3D'mso-bidi-font-weight:normal'><span style=3D'font-size:14.0pt'><o:p=
></o:p></span></b></p>

<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><b style=3D=
'mso-bidi-font-weight:
normal'><span style=3D'font-size:14.0pt'>Liability Waiver<o:p></o:p></span>=
</b></p>

<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><b style=3D=
'mso-bidi-font-weight:
normal'><span style=3D'font-size:14.0pt'><o:p>&nbsp;</o:p></span></b></p>

<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><b style=3D=
'mso-bidi-font-weight:
normal'><span style=3D'font-size:14.0pt'><o:p>&nbsp;</o:p></span></b></p>

<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><b style=3D=
'mso-bidi-font-weight:
normal'><span style=3D'font-size:14.0pt'><o:p>&nbsp;</o:p></span></b></p>

<p class=3DMsoNormal><span style=3D'font-size:11.0pt;font-family:"Century S=
choolbook"'>The
undersigned being over the age of twenty-one (21), does hereby request to
participate in the City of Fort Oglethorpe Citizens Police Academy including
permission to ride as an <b style=3D'mso-bidi-font-weight:normal'>observer =
and
student</b> in a motor vehicle operated by a police officer with the City of
Fort Oglethorpe.<span style=3D'mso-spacerun:yes'>&nbsp; </span>If permissio=
n is
granted, I agree at all times to obey all orders, instructions and commands
given to me by any police officer, employee, or agent of the Fort Oglethorpe
Police Department during the time of my participation in this program.<o:p>=
</o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:11.0pt;font-family:"Century S=
choolbook"'><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:11.0pt;font-family:"Century S=
choolbook"'>I
fully realize and understand that Law Enforcement work by its very nature is
dangerous and that I am subjecting myself to potential situations that may
result in property damage, injury, or death. Further I understand that prop=
erty
damage, injury or death may occur as a result of a motor vehicle accident
during my ride-along observations.<span style=3D'mso-spacerun:yes'>&nbsp;
</span>I also understand that participation in any demonstrations or practi=
cal
exercises as part of the Citizens Police Academy can be hazardous and may
result in property damage, injury, or death. Knowing and understanding these
risks, I nevertheless freely accept these risks and accept full responsibil=
ity
for myself for any property damage, injury or death that may occur as a res=
ult
of the granting of this request, the ride-along, and any participation in t=
he
class sessions.<o:p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:11.0pt;font-family:"Century S=
choolbook"'><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:11.0pt;font-family:"Century S=
choolbook"'>In
consideration of the educational benefit to be received by me and other
valuable consideration upon granting of this request, I, my heirs and my
estate, agree to hold harmless individually and in their official capacity,=
 any
and all City of Fort Oglethorpe police officials, employees, agents from <b
style=3D'mso-bidi-font-weight:normal'>ALL LIABILITY </b>to me for property
damage, injury or death sustained as a result of granting of this request
during the period of time I participate in the Citizens Police Academy
Program.<span style=3D'mso-spacerun:yes'>&nbsp; </span>I, my heirs, and my =
estate
further agree to hold harmless the City of Fort Oglethorpe, Georgia and all
employees, officers and elected officials<span class=3DGramE>, <span
style=3D'mso-spacerun:yes'>&nbsp;</span>individually</span> and in their of=
ficial
capacity from <b style=3D'mso-bidi-font-weight:normal'>ALL LIABILITY </b>to=
 me
for property damage, injury or death sustained as a result of the granting =
of
this request while I participate in the CITIZENS POLICE ACADEMY PROGRAM.<o:=
p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:11.0pt;font-family:"Century S=
choolbook"'><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>___________________________<span style=3D'mso-tab-coun=
t:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>__________________________</p>

<p class=3DMsoNormal><b style=3D'mso-bidi-font-weight:normal'><span
style=3D'font-size:9.0pt'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span></b><b style=3D'mso-bidi-font-weight:normal'><span
style=3D'font-size:8.0pt'>(PRINT NAME)<span style=3D'mso-tab-count:5'>&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp; </span><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp; </span>(NOTARY PUBLIC)<o:p></o:p></=
span></b></p>

<p class=3DMsoNormal><b style=3D'mso-bidi-font-weight:normal'><span
style=3D'font-size:8.0pt'><o:p>&nbsp;</o:p></span></b></p>

<p class=3DMsoNormal><span style=3D'font-size:8.0pt'><o:p>&nbsp;</o:p></spa=
n></p>

<p class=3DMsoNormal><span style=3D'font-size:10.0pt'>_____________________=
___________<o:p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:10.0pt'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp; </span></span><b
style=3D'mso-bidi-font-weight:normal'><span style=3D'font-size:8.0pt'><span
style=3D'mso-spacerun:yes'>&nbsp;&nbsp;</span>(SIGNATURE</span></b><span
style=3D'font-size:8.0pt'>)<o:p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:10.0pt'><o:p>&nbsp;</o:p></sp=
an></p>

<p class=3DMsoNormal><span style=3D'font-size:10.0pt'>_________/___________=
__/_________<o:p></o:p></span></p>

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