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NEWPORT POLICE DEPARTMENT ASSUMPTION OF RISK

LIABILITY WAIVER AND CLAIMS RELEASE

I. I understand that police work, and in particular, accompanying a police officer on official duties,

may expose me to danger and to the risk of bodily injury or loss of life. While I am with such

officer, I may be subject to inherently dangerous activities, including but not limited to high speed

vehicular pursuit, apprehension of person believed to have engaged in criminal activity, rescue

operations, use of weapons, chemicals (such as O.C. spray), incendiary devices and other dangerous

instrumentalities. I understand that the officer will be fully involved in his/her normal duties and I

will be subjected to all of the risks normally associated with police work, including the possibility

of vehicular collisions, gun fire, assault and other mishap, which could result in property damage,

injury or loss of life.

II. When the Newport Police Department permits me to accompany such police officer. I assume all

of the risks associated with the activities mentioned above, including but not limited to the risk that

I may suffer property damage, personal injury and or death.

III. I agree that the City of Newport, it’s officers, employees and representatives, including but not

limited to members of the Newport Police Department, shall not be responsible or liable for any

loss, damage, liability or expense caused by, or arising out of the above described activity. I waive

any claims that I may have against the City and such persons, whether arising in whole or in part

on account of the negligence of the City and such persons.

IV. While I am engaged in such activity, I agree to follow any lawful directives of the police officers

with whom I may come in contact. I understand that my role is an observer, and I agree that I will

not attempt to participate or otherwise become involved in the activities being carried out by such

officer.

V. I agree that I will save, hold, defend and indemnify the City of Newport, its officers, employees

and representatives, harmless on account of any loss, damage, liability, claim, demand or expense

arising on account of act or omission of such person, or arising as a result of any loss or injury

suffered by such person.

VI. I will not carry any weapon on or about my person unless I am a duly sworn and appointed police

officer in good standing within the State of Oregon. As a sworn police officer I will notify the

officer with whom I am riding of said status and advise them of any weapon that I am carrying on

or about my person.

STOP! READ THIS DOCUMENT CAREFULLY BEFORE SIGNING. THIS DOCUMENT

AFFECTS YOUR LEGAL RIGHTS. BY SIGNING YOU ARE CERTIFYING THE ACCURACY

OF THE STATEMENTS CONTAINED AND AGREEING TO ASSUME RISK, WAIVE CLAIMS

I certify that I have read and agree to all of

AND UNDERTAKE CERTAIN OBLIGATIONS.

the above.

Signed: _____________________________

Date signed: _____________

Printed Name: ________________________

(If the above named person is a minor) I __________________________ represent that I am the parent or

lawful guardian of the above named person, and I have the lawful authority to execute this agreement for

and on behalf of the above named person. I have read and understand the foregoing, and I certify that its

contents are true. I agree to each and every provision of the foregoing and give my consent for said minor

person to engage in the above described activity. I agree that I will save, hold, defend and indemnify the

City of Newport, its officers, employees and representatives, harmless on account of any loss, damage,

liability, claim, demand or expense arising on account of my own acts or omissions of such person, or

arising as a result of any loss or injury suffered by such person.

Signed: _____________________________

Date signed: _____________

Parent/Guardian Signature

Y:\NPD\Shared\Forms\Ride Along Application revised 11/2013

Ride Along Application Form/liability Waiver And Claims Release - Newport Police Department Assumption Of Risk

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