VOLUNTEER LIABILITY WAIVER AND RELEASE FORM
 
What is your name:
Will you be: Working
Accompanying
Department Member:
Where: Shelter
Vehicle
AC#
On what date:
For what purpose:

I AM AWARE THAT THERE ARE VARIOUS HAZARDS WHICH MAY BE ENCOUNTERED, INCLUDING BUT NOT LIMITED TO: TRAFFIC ACCIDENTS, AGGRESSIVE ANIMALS, VIOLENT AND/OR ABUSIVE MEMBERS OF THE PUBLIC AT LARGE, ETC...... BEING INFORMED OF THIS INFORMATION, I AM SIGNING THIS DOCUMENT OF MY OWN FREE WELL AND DO RELIEVE AND RELEASE THE CALCASIEU PARISH POLICE JURY, DIVISION OF ENGINEERING & PUBLIC WORKS, DEPARTMENT OF ANIMAL CONTROL AND IT'S EMPLOYEES AND/OR VOLUNTEERS OF ALL RESPONSIBILITIES AND LIABILITIES FROM ANY AND/OR ALL PERSONAL INJURY, LOST, STOLEN OR DAMAGED ARTICLES TO MYSELF.