Create an Account - Increase your productivity, customize your experience, and engage in information you care about.
The obligations of confidentiality which professional code of ethics and HIPAA Laws have placed upon the Firefighter/EMT also applies to all other personnel who are riding with and working with members of the Fairborn Fire Department. Under no circumstances may any information gained within the activities of the Fairborn Fire Department from any patient, EMT, or otherwise be divulged to any person except in the course of duty.Any infraction of this obligation of confidentiality will result in removal from the Ride-Along Program. I agree to accept the above obligations as part of the responsibilities of working with the members of the Fairborn Fire Department.
In consideration of the permission granted to me by the City of Fairborn, Ohio, to accompany Firefighter/Paramedics of the Fairborn Fire Department in the course of their duties, I and/or my parent or legal guardian hereby waive all claims for damage, personal injury, or loss to my person and property which may be caused by an act or omission of the City of Fairborn, its officers, agents, or employees.We assume the risk of all dangerous conditions or occurrences which may be encountered during said functions and waive any and all specific notice of the existence of such incidents or occurrences. Further, we hereby covenant not to sue the City of Fairborn, its agents, officers, or employees for any claim arising out of any act or condition occurring during said functions and agree that this waiver and convenient not to sue shall be binding on my executors, administrators, heirs and assigns.This waiver of claims and covenant not to sue covers any and all functions for as long as I attend the functions.
This field is not part of the form submission.
* indicates a required field