PLYMOUTH COUNTY SHERIFF’S DEPARTMENT



[pic]PLYMOUTH COUNTY SHERIFF’S DEPARTMENT

26 Long Pond Road, Plymouth, MA 02360

INDEMNITY AGREEMENT – VOLUNTARY STAFF USE OF FITNESS CENTER

Name:____________________________________ Title:_________________________

In case of medical emergency, contact: ________________________________________

Relationship:__________________________Phone Number:______________________

RELEASE OF ALL CLAIMS/LIABILITY RELEASE

I have read this form and understand that in exchange for the opportunity to use the fitness center at the Plymouth County Correctional Facility, I agree to indemnify and hold harmless, release and forever discharge the Plymouth County Sheriff’s Department, Plymouth County Correctional Facility Corporation, Plymouth County, their officers, employees, agents, successors and assigns, from any and all manner of action, suits, claims, demands, judgments, damages and liability in law and in equity including costs and reasonable attorney’s fees. The terms herein shall serve as a release not only for myself but also apply to my heirs, executors, administrators, personal representatives and for all members of my family. In signing this form I acknowledge that the Plymouth County Sheriff’s Department, Plymouth County Correctional Facility Corporation and Plymouth County have relied upon the good faith execution and delivery of this form. By signing this form I assume the risk of any and all injuries, and the consequences thereof, which may occur while using the facility fitness center.

VOLUNTARY STAFF USE OF FITNESS CENTER

I further recognize that I use the fitness center as a purely voluntary recreational activity, not related to my employment with the Sheriff’s Office.

ACKNOWLEDGEMENT OF POLICIES AND REGULATIONS

I understand that I am to abide by all facility policies and regulations, particularly those relating to security. I understand that unauthorized items including cell pones, weapons and medication must not be brought into the institution or any area beyond the employee main parking lot without the prior approval of the Sheriff or the Superintendent. I understand that electronic equipment including MP3 players and IPods must not be brought beyond the secure perimeter of the institution.

Should any of the terms and conditions of this agreement be found to be in violation of any federal law, state law or by a court of competent jurisdiction, such other provisions of this agreement as may not be affected shall remain in full force and effect.

CAUTION: BEFORE YOU BEGIN ANY EXERCISE PROGRAM YOU SHOULD CONSULT YOUR PHYSICIAN.

I have read and understand this form and freely agree to the terms as expressed in return for use of the facility fitness center.

Staff member’s signature:_____________________________________Date:_________

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download