ARKANSAS POLICE OLYMPICS

RELEASE OF LIABILITY FORM

For and in consideration for the granting of permission to participate(s) in the 2010 Arkansas Police Olympics, the undersigned hereby releases any and all persons or organizations connected with or attending the 2010 Arkansas Police Olympics games or events from any liability for damages arising out of injury of any sort or nature suffered by the undersigned by reasons of his/her participation in any event or activity of the games.

Event:__________________________________________________

Team Name:_____________________________________________

Date:___________________

Competitors Names:

1.__________________                      11._____________________

2.__________________                      12._____________________

3.__________________                      13._____________________

4.__________________                      14._____________________

5.__________________                      15._____________________

6.__________________                      16._____________________

7.__________________                      17._____________________

8.__________________                       18._____________________

9.__________________                      19._____________________

10.___________________                            20._______________________