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Citizens Fire Academy Application and Release
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Date of Birth
Do you have any of the following medical conditions that may cause physical limitations?
None of the Above
If other, please list here:
Certain activities in the Citizen Fire Academy program may be physically demanding. Individuals with the aforementioned medical conditions should consult with their personal physician prior to participating in these physical activities. Participation in any portion of the program is voluntary; you do not need to take part in any activity that you are not comfortable with.
All applicants must be 21 years of age and live in the city limits of Maumelle Arkansas. I hereby ensure that all of the information that I have submitted on this Citizens Fire Academy application for is true and accurate. I understand that the Fire Department reserves the right to accept or reject any applicant for the Citizen Fire Academy.
Wavier of Liability and Hold Harmless Agreement
FOR AND IN CONSIDERATION OF being permitted to attend the Citizen Fire Academy for the City of Maumelle Arkansas, as well as being able to use certain property owned by the City of Maumelle and being allowed to participate in certain demonstrations and fully advised and acknowledging the inherit danger of these activities, I on behalf of myself and my heirs, executors , administrators , attorneys, and assigns, hereby waive, release and forever discharge the City of Maumelle its successors and assigns (hereinafter Collectively referred to as" Releasees"), from any and all known and unknown actions, causes of action, claims or liabilities of any kind which have or could be asserted against the Releasees arising out of participation in the Citizens Fire Academy for the City of Maumelle Arkansas. I FURTHER UNDERSTAND THAT THIS WAVIER OF LIABILITY AND HOLD HARMLESS AGREEMENT INCLUDES A RELEASE OF ALL KNOWN AND UNKNOWN CLAIMS. I acknowledge and agree that if any provision of this Wavier of Liability and Hold Harmless Agreement is found, held or deemed by a court of competent jurisdiction to be void, unlawful or unenforceable under any applicable statue or controlling law, the remainder of this Waiver of Liability and Hold Harmless Agreement shall continue in full force and effect. This release contains the ENTIRE AGREEMENT between the parties hereto, and the terms of this release are contractual and not a mere recital. I further acknowledge and agree I have carefully read and fully understand all of the provisions of this Waiver of Liability and Hold Harmless Agreement and that I voluntarily enter into this Wavier of Liability and Hold Harmless Agreement by Signing and Dating below.
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