Vehicle Release of Liability

I   First Name*   Last Name*   have requested that the Salt Lake City Fire Department (“SLCFD”) assist me in accessing my locked vehicle in order to preserve the health and safety of a person or animal locked inside. An SLCFD employee has explained to me, and I hereby acknowledge, that damage may occur to my vehicle as a result of such actions. In consideration for SLCFD accessing the vehicle per my request and on my behalf, I hereby assume all responsibility for any damage caused by SLCFD in accessing the vehicle and voluntarily release, forever discharge, and agree to hold harmless and indemnify Salt Lake City Corporation, its agents or employees, and all other persons or entities from any and all liability, claims, demands, actions or rights of actions, which are related to, arise out of, or are in any way connected with accessing my vehicle. I hereby sign this document after full consideration and of my own free will and choice.

Signature      Date*