Form PDS332 "Request for Participation and Waiver of Liability Ride Along Training Program" - County of San Diego, California

What Is Form PDS332?

This is a legal form that was released by the Planning and Development Services - County of San Diego, California - a government authority operating within California. The form may be used strictly within County of San Diego. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 24, 2012;
  • The latest edition provided by the Planning and Development Services - County of San Diego, California;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form PDS332 by clicking the link below or browse more documents and templates provided by the Planning and Development Services - County of San Diego, California.

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Download Form PDS332 "Request for Participation and Waiver of Liability Ride Along Training Program" - County of San Diego, California

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County of San Diego, Planning & Development Services
REQUEST FOR PARTICIPATION AND
WAIVER OF LIABILITY RIDE ALONG
TRAINING PROGRAM
BUILDING DIVISION
I,
a private citizen, request that I be allowed to ride as a
Full Name (Printed)
passenger and/or observer in a County or private vehicle on a regular building inspection assignment
on _______________________ (date and year).
I make this request with full knowledge that I may be exposing myself to some risk of bodily harm,
including but not limited to, the risk of injuries resulting from the operation and use of a motor vehicle,
and the risk of injuries inherent in participating, even as an observer, in building inspection activities
at construction sites.
I further understand that the primary duty of the Building Inspector with whom I will be riding may
prevent said Inspector from making any provision for my personal protection under many
circumstances and that neither the Inspector, Planning and Development Services, nor the County of
San Diego can completely guarantee my personal safety.
I agree that unless I am a County
employee, I will not enter private property without the consent of the property owner or legal
occupant.
In consideration for being allowed to ride along with a Building Inspector as requested, and with full
knowledge and appreciation of the risks involved, I voluntarily agree to, and do hereby, assume all
risks of physical harm in connection with this request.
I further agree not to bring any claim or suit with respect to any injuries I may sustain against the
State of California, the County of San Diego, Planning & Development Services, or any of the County
staff, and I agree to hold them harmless from and indemnify them for any and all claims, demands,
suits, and liability which might possibly arise out of my participation in this program as requested
herein. I further agree that I may be subject to a background check before the County determines
whether to authorize my participation in this program.
I will follow the instructions of the Building Inspector with whom I will be riding and will wear a hardhat
on any construction site.
I certify that I am at least 18 years of age (unless parents’ signatures appear below).
BY MY SIGNATURE BELOW, I CERTIFY THAT I HAVE READ THIS "REQUEST FOR
PARTICIPATION AND WAIVER OF LIABILITY" BEFORE SIGNING IT AND I FULLY UNDERSTAND
ITS CONTENTS.
_______________________________________
___________________
Signature
Date
5510 OVERLAND AVE, SUITE 110, SAN DIEGO, CA 92123 ● (858) 565-5920 ● (888) 336 -7553
HTTP://WWW.SDCPDS.ORG
PDS 332 REV.: 09/24/2012
PAGE 1 of 2
County of San Diego, Planning & Development Services
REQUEST FOR PARTICIPATION AND
WAIVER OF LIABILITY RIDE ALONG
TRAINING PROGRAM
BUILDING DIVISION
I,
a private citizen, request that I be allowed to ride as a
Full Name (Printed)
passenger and/or observer in a County or private vehicle on a regular building inspection assignment
on _______________________ (date and year).
I make this request with full knowledge that I may be exposing myself to some risk of bodily harm,
including but not limited to, the risk of injuries resulting from the operation and use of a motor vehicle,
and the risk of injuries inherent in participating, even as an observer, in building inspection activities
at construction sites.
I further understand that the primary duty of the Building Inspector with whom I will be riding may
prevent said Inspector from making any provision for my personal protection under many
circumstances and that neither the Inspector, Planning and Development Services, nor the County of
San Diego can completely guarantee my personal safety.
I agree that unless I am a County
employee, I will not enter private property without the consent of the property owner or legal
occupant.
In consideration for being allowed to ride along with a Building Inspector as requested, and with full
knowledge and appreciation of the risks involved, I voluntarily agree to, and do hereby, assume all
risks of physical harm in connection with this request.
I further agree not to bring any claim or suit with respect to any injuries I may sustain against the
State of California, the County of San Diego, Planning & Development Services, or any of the County
staff, and I agree to hold them harmless from and indemnify them for any and all claims, demands,
suits, and liability which might possibly arise out of my participation in this program as requested
herein. I further agree that I may be subject to a background check before the County determines
whether to authorize my participation in this program.
I will follow the instructions of the Building Inspector with whom I will be riding and will wear a hardhat
on any construction site.
I certify that I am at least 18 years of age (unless parents’ signatures appear below).
BY MY SIGNATURE BELOW, I CERTIFY THAT I HAVE READ THIS "REQUEST FOR
PARTICIPATION AND WAIVER OF LIABILITY" BEFORE SIGNING IT AND I FULLY UNDERSTAND
ITS CONTENTS.
_______________________________________
___________________
Signature
Date
5510 OVERLAND AVE, SUITE 110, SAN DIEGO, CA 92123 ● (858) 565-5920 ● (888) 336 -7553
HTTP://WWW.SDCPDS.ORG
PDS 332 REV.: 09/24/2012
PAGE 1 of 2
If rider is under 18 years of age, parent(s) must sign below.
I/We have read and join in making the foregoing Request for Participation And Waiver of Liability on
behalf of myself/ourselves and of my/our minor child, whose signature appears above.
________________________________ __________________________________
Father
Mother
DEPARTMENT ACKNOWLEDGEMENT BY SIGNATURES
_____________________________________________________________________
Approval
(Building Division Chief)
Date
_____________________________________________________________________
Approval
(Building Inspector)
Date
PDS 332 REV.: 09/24/2012
PAGE 2 of 2
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