City
Evansville
State
Zip
47713
Liability Statement
I understand that at all times the child restraint must be used in accordance with the instructions provided by the manufacturer of the child restraint and the instructions provided by
the vehicle manufacturer. I also understand that if I do not use the child restraint as stated in the manufacturers' instructions, the child restraint may not be effective in a crash.
By signing below, I indicate that I have read this form, understand it, and agree to accept any and all responsibility for any misuse of the child restraint device or any installation
contrary to the manufacturers' instructions. I also agree to release the Vanderburgh County Health Department and anyone for whom they may be legally responsible from any
present or future liability for any injuries or damages that may result from a vehicle collision or otherwise.
the vehicle manufacturer. I also understand that if I do not use the child restraint as stated in the manufacturers' instructions, the child restraint may not be effective in a crash.
By signing below, I indicate that I have read this form, understand it, and agree to accept any and all responsibility for any misuse of the child restraint device or any installation
contrary to the manufacturers' instructions. I also agree to release the Vanderburgh County Health Department and anyone for whom they may be legally responsible from any
present or future liability for any injuries or damages that may result from a vehicle collision or otherwise.
Agency Name
Vanderburgh County Health Department
Liability Statement Spanish
Entiendo que el Sistema de retención infantil debe utilizarse en todo momento de acuerdo con las instrucciones proporcionadas por el fabricante del sistema de retención infantil y las instrucciones proporcionadas por el fabricante del sistema del vehículo. También entiendo que si no uso el asiento de seguridad para niños como se indica en las instrucciones del fabricante, es posible que el asiento de seguridad para niños no sea efectivo en un choque. Al firmar a continuación, afirmo que he leído este formulario, lo comprendo y acepto toda la responsabilidad por el uso indebido del dispositivo de retención infantil o cualquier instalación contrario a las instrucciones del fabricante . También estoy de acuerdo en liberar al Depertamento de Salud del Condado de Vanderburgh y a cualquier persona de la que puedan ser legalmente responsables de cualquier responsabilidad presente o futura por cualquier lesión o daño que pueda resultar de un accidente del vehículo o de otra manera.