<p> HOLD HARMLESS AGREEMENT</p><p>______, agrees to release and hold harmless the Charlotte County Airport Authority, a political special district of the State of Florida, its officers, agents, employees, and volunteers from all suits and actions, including attorneys’ fees and all costs of litigation and judgment of every name and description brought against the Airport as a result of loss, damage or injury to person or property by reason of any act or failure to act resulting from the participating in the 2014 Punta Gorda Airport Triennial Emergency Drill at the Punta Gorda Airport.</p><p>In witness hereof, I have executed this release on ______, 2014.</p><p>______Signature </p><p>______Full Name (Last, First and Middle) </p><p>Date of Birth: __ __/__ __/ __ __ (Mo/Day/Yr)</p><p>Last 4 of SSN: xxx-xx-( ______)</p><p>______Parental Signature *Required if under 18</p><p>** Information Above is also used to verify against the TSA NO-Fly List</p><p>Please Return Waiver Before October 7th 2014 to: Mail: Fax: Email: CCAA (941) 639-6214 [email protected] Attn: Ben Duke 28000 A-1 Airport Road Punta Gorda, FL, 33982</p>