SECTION 1 – Agreement
Date:
I,	of
,
Street Address
City of	, County of	, State of	,
City	County	State
am about to take a flight or flights on this date, at my request and voluntarily, as an unofficial passenger in an aircraft owned, operated, or otherwise controlled by the Commonwealth of Virginia, Department of Forestry, its officers, employees, designated representatives and agents (hereinafter “the Commonwealth”). I have not compensated and will not compensate the Commonwealth for this flight or these flights, whether by money or exchange of goods or services of value. I am not a paying passenger, but merely a licensee, whole permission may be revoked by the Commonwealth at any time for any reason. In consideration of this permission, for myself or any person empowered to act on behalf of me or my estate, I hereby release, waive and forever discharge the Commonwealth from any and all claims and demands, present and future, arising from or by reason of any personal injury (including death) or property damage resulting any accident which may occur as a result of such flight or flights, even though such personal injury, death or property damage may have resulted from negligent acts or omissions of the Commonwealth. I make this release with the knowledge that air travel under the best of circumstances poses significant risks. Where the flight takes place under less ideal circumstances, e.g., in connection with fire observation or response etc., I recognize that the risks are greatly increased. Furthermore, I promise that preceding, during and following the flight or flights, I will follow the instructions of the pilot and other Commonwealth personnel. I further release the Commonwealth from any claims whatsoever on account of first aid, treatment or service rendered me during and following my participation in such flight or flights. I hereby agree to indemnify the Commonwealth of Virginia from any loss, liability, damage or cost it may incur due to my participation in such flight or flight. The term “flight or flights” as used above includes the preparation for, continuation and completion of flight or flights whether or not one or more aircraft is used throughout the entire flight or flights, as well as all ground or flight operations incident thereto. I expressly agree that this release, waiver and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the Commonwealth of Virginia, and that if any portion thereof is held invalid, it is agreed that the balance shall, not withstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto and the terms of this release are contractual and not a mere recital. I have carefully read the foregoing release and know the contents thereof and fully understand that by signing it, I do consent to the release of all liability of the Commonwealth of Virginia with regard to the flight(s) I am about to take. I sign this release as my own free act.
Name (Print)	Signature	Date