Secure Access For First Responders, LLC 

This form is to be completed and signed by Resident and given to installer at time of installation.

Secure Access For First Responders, LLC (SAFFR)

21 Cuenca Cir.

Hot Springs Village, AR 71909


Secure Access for First Responders, LLC (SAFFR)

Liability Release Form

On this, the _______ day of _____________, 201_, intending to be legally bound hereby, the undersigned agrees and does hereby release from liability and indemnify and hold harmless Secure Access For First Responders, LLC™; the __________________________Police Department; the ____________________________Fire Department; LifeNet the ___________________________________, and any of their employees, members, managers, officers, representatives, agents and emergency personnel, from and against any and all claims, lawsuits, liabilities, judgments, damages. losses and expenses of any kind or nature, including personal injury or death; property damage, destruction or other impairment; and all costs and expenses, including attorneys’ fees and expenses, arising from or related to the undersigned participation in the Secure Access For First Responders, LLC™ Program.

Participant understands and hereby acknowledges and agrees to provide a key to the Participant’s home for the Hot Springs Village Police/Fire Departments; said key to be placed into a Key Safe (wall-mount combination lockbox), that will be locked and secured to the exterior of the participant’s dwelling.

It is understood and agreed that the aforementioned personnel and related emergency First Responders may use this key safe to access said key and enter participant’s home if necessary, in case of an emergency.

_________________________________________ ________                ________________________________________________                           

Signature of Program Participant                                                     Address of Program Participant              

____________________________________________________            ________________________________________________

Name of Program Participant (Please Print)                                                Telephone