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Observer Waiver Form

Regulations: 
• You must attach a copy of your current CPR card and state-issued ID card to this form.

• You are to follow all directions of the attendant in charge and any other staff and members.

• You shall dress in a neat and clean manner, Observer will be expected to wear a plain white collared shirt, or class-issued t-shirt with navy blue or black pants (no sweatpants or jeans), and plain black closed-toe shoes. Your clothing may not bear the IWVRS/IOWFR logo. 

• You may not release any information about a call or patient to anyone outside of the crew you are observing.

• The attendant in charge may decide if you are able to ride as an observer for any call due to the nature of the call. 

• This privilege may be revoked at any time by an officer or Attendant in charge of the crew.

Required   Indicates Required Field
Name of applicant: Required
Phone Number: Required
Email: Required
Date Requested for Observer Shift: Required
CPR Card: Required
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State Issued ID Card/Drivers License : Required
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Upload Name Below (Parent/Guardian name if under 18):
I________________________, in consideration of the benefits derived from participating as an observer with the Isle of Wight Volunteer Rescue Squad (including Isle of Wight Department of Fire Rescue) on (date) do hereby waive and revoke all claims of liability I may hold deriving from legitimate operations of said squad. I have read and understand the above regulations covering riding as an observer and I agree to follow them. Furthermore, Squad activities my be inherently dangerous because of the multiple hazards encountered by emergency service response. Such hazards include but are not limited to, the risk of accident, injury from a bystander or traffic, exposure to communicable and/or infectious diseases, which diseases may or may not be known to responders, and which diseases may not be curable and may adversely affect the health of the undersigned or cause disablement or death to the undersigned. It is further understood that it is impossible for Squad personnel to ensure the complete safety of the undersigned.
Required




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