Participation in all sessions is expected.  There may be the possibility to allow for make-ups, and all conflicts should be discussed with the instructor.

TOWN OF NEW CANAAN
CERT Program
HOLD HARMLESS/PERMISSION REQUEST

I, hereby request permission to participate in the New Canaan Community Emergency Response Team (CERT) program.

I understand that this training will involve active physical participation, which includes a potential risk of personal injury and/or personal property damage. I make this request with full knowledge of the possibility of personal injury and/or personal property damage.

Further, I have read and understand the program outline that describes all class sections and the associated activities.

I agree to hold The Town of New Canaan, Town of New Canaan Emergency Management, New Canaan Fire Department, and their agents and personnel harmless from any  and all claims, actions, suits, and/or injury that I may suffer and which may arise as a result of my participation in the above mentioned program.

I agree to follow the rules established by the instructors, and to exercise reasonable care while participating in the CERT program. I understand that if I fail to follow the instructor’s rules and regulations or if I fail to exercise reasonable care, I can be administratively removed from the program.

By executing this release, I certify that I have read this release in its entirety, understand all of its terms, and have had any questions regarding the release or its effect satisfactorily answered. I sign this release freely and voluntarily.