BrazosCounty Precinct 4 Fire Department
PO Box 4186
Bryan, TX77805-4186
979-775-0194
979-775-0123 fax
I ______Have accepted full responsibility for any damages that may occur on my behalf as a result of staying at the Brazos County Pct. 4 Fire Department Fire Station.
I understand that any actions or behaviors that are inappropriate for Firefighter or the Fire Service will be grounds for removal from the fire station and property.
The following are and not limited to the appropriate actions:
- No personal phone calls made or received from station phone
- No alcohol on premises
- Being Intoxicated on Premises prohibited
- No illegal activity on or off premises
- No guests on property
- No coming or going between hours of 12am to 6am
I understand that I am a guest and that at any time I could be asked to leave.
I understand that my stay will start on ____/____, 2006 and I will leave on ____/____, 2006.
I understand that I will be issued keys to the station that Will be returned on ___/___, 2006 and that no copies are to be made. A fee of 500.00 will be charged should these keys be lost or not returned.
- Fire Station Key to outside doors
- Key to Dorm Area, Second Floor
- Key to Bedroom #1
I understand that BrazosCountyPct. 4 Fire Department will not be responsible for any damages, injuries, etc., as a result of my stay.
I will provide:
- Copy of, my Drivers License. ______
- Correct address and phone number. ______
The undersigned hereby agrees to indemnify, defend, and hold harmless the Brazos County Precinct 4 Volunteer Fire Department against any such claims brought by any person or entity on my behalf. The undersigned has read and hereby agrees to all the conditions of the agreement.
______
Print NameSignatureDate
Approved by:
______
Joe Ondrasek, Fire ChiefDate