Car Safety Seat Release Form

I acknowledge, understand and agree that the purpose of this child safety seat installation program (Program) is to help reduce, the incidence of the improper installation of child safety seats. This inspection is being provided to me as a free service. I acknowledge, understand and agree that this Program cannot fully evaluate the quality, safety, or condition of the car seat, or any component of my vehicle, including the seats or safety belts; and that this Program cannot guarantee my child’s safety should my vehicle my vehicle containing the inspected car safety seat be involved in an accident.

For these reasons, and in consideration of participation in this Program by St Charles County Ambulance District, its affiliates, agents, representatives, employees, attorneys, legal representatives, brokers, predecessors-in-interest, successors-in-interest, assigns, trustees, and administrators and any other person, representatives or entity related to or involved therewith (hereinafter collectively referred to as SCCAD), it is the purpose and intent of this agreement to exempt, waive and relieve SCCAD from liability for personal injury, property damage, and wrongful death, including if caused by the negligence, fault, or failure to use due care of SCCAD.

I waive, release and relinquish any and all claims of mine or my children for liability and cause(s) of action, including for personal injury, property damage or wrongful death occurring for arising out of any modification(s) made by SCCAD or its agents to the positioning or securing of the child safety seat in my vehicle, the failure to make any modifications to the positioning or securing of the child safety seat in my vehicle, or arising generally out of my participation in the Program.

I acknowledge, understand and assume all risks relating to the future use of my car safety seat regardless of the accuracy of the information contained on the Child Safety Seat Checklist, modification(s) made to the positioning or securing of the child safety seat in my vehicle, or the failure to make any modification to the positioning or securing of the child safety seat in my vehicle, whichever or however those risks occur. I acknowledge and understand that these risks and dangers may be caused by the negligence, fault or failure to use due care of SCCAD are included within the waiver, release and relinquishment described in this document.

I further acknowledge that there may be risks and dangers not known to me or not reasonably foreseeable at this time. I acknowledge, understand and agree that all of the risks and dangers described throughout this agreement, including those caused by the negligence, fault, or failure to use due care of SCCAD are included within this waiver, release, and relinquishment described in this document.

If the law in any controlling jurisdiction renders any part of this agreement unenforceable, the remainder of this agreement shall nevertheless remain enforceable to the full extent, if any, allowed by controlling law.

I understand that this agreement affects my legal rights, and that I may consult an attorney concerning this agreement. I agree if any claim for my or my children’s personal injury, injury to my property, or wrongful death is commenced against SCCAD, I shall defend, indemnify, and save harmless SCCAD from any and all claims or causes of action by whomever or wherever made or presented for my prersonal injuries, property damage or wrongful death. I acknowledge that I have been provided and have carefully read this document and have not relied upon any representations of SCCAD in so doing; that I am fully advised of the potential risks of participation in this Program and understand my execution of this document is being relied on by SCCAD for its participation in this Program.