Ventura County Sheriff’s OfficeVolunteer, Non-Employee, Guest, Observer

Agreement Assuming Risk of Injury or DamageWAIVER AND RELEASE OF CLAIMS

READ THIS DOCUMENT BEFORE COMPLETING & SIGNING

Full Name (First/Middle/Last):

Date of Birth:

Home Address:

Phone Number:( ) E-mail Address:

Street City State Zip Code

Month Day Year

Signature Date

2019 Waiver and Release of Claims.DOC AMG1599

Whereas the undersigned, not being a member, employee, or agent of any law enforcement department, has made a voluntary request for permission to act as an observer, guest, or volunteer in the Ventura County Jail and has requested permission to accompany and/or work with the assigned personnel of the Ventura County Jail during the performance of their official duties; And, whereas, the undersigned acknowledges that the work and activities of said Ventura County Jail at any time can be dangerous involving possible risk of injury, damage, expense, or loss to person or property. It is understood that the Ventura County Sheriff’s Office has a strict “No Hostage” policy, which means that no inmate will be allowed to leave a detention facility because of the taking of a hostage. Force may be necessary to rescue hostages. This policy will be applied in all cases without regard to sex, age, or status of any hostage. Now, therefore, be it understood that the undersigned hereby agrees that the County of Ventura, the Ventura County Sheriff’s Office, Detention Services Division, and each of them shall not be held liable or responsible under any circumstances whatsoever by the undersigned, his or her estates, or heirs, for any injury, damage, expense, or loss to the person or property of the undersigned, incurred while acting as a guest-observer within the confines of the Ventura County Jail or while accompanying a staff member of the Ventura County Jail during the active performance of his/her official duties.

The undersigned: Has read this waiver and release of claims and fully understands its contents; is aware that this release is a waiver of liability and that he/she will not be able to sue the persons and/or entities named herein’ and has signed this release voluntarily and of free will.

For Sheriff’s Office Review / Do Not Write Below Line

Classification Deputy: RB#/FI#: Date:

Classification Supervisor: Approved: YES / NO

Clearance Expiration Date:

AA/NA Teacher/Student Tour Religious Services Contractor Other:

VCSO Staff Member Requesting Clearance: Phone: ( )

Purpose for Jail Access:

Full Name (First/Middle/Last):

All Other Names Used (ie. Maiden/Alias/aka):

Home Address:

Phone Number:( ) E-mail Address:

Employer/School: Contact Number: ( )

Drivers License/ID Card Number: Expiration:

Date of Birth: Height: Weight: Hair: Eyes:

Place of Birth: Social Security Number:

List any other state(s) you have been issued a drivers license below.

State/License Number State/License Number State/License Number

This information is necessary for processing jail clearances. To avoid delays in this process it is important that you fill this form out completely. Your signature is necessary to authorize the Sheriff's Office to check this information. Your address with DMV must be current. An incorrect address on file with DMV will stop the process.

Ventura County Sheriff’s OfficeDetention Services

SECURITY CLEARANCE REQUEST FORM

Street City State Zip Code

City/State

2019 Security Clearance Requests.DOC AMG1599

Signature Date

Todd Road Jail Health and Programming Unit Expansion

Melissa Smith 805 933-8517