Assessment Sign-Up

Homeowner Information

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Additional Notes

Fire Safe Santa Cruz County - Home Ignition Zone Assessment Liability Waiver

By requesting this Home Ignition Zone (HIZ) Assessment, I understand and agree to the following:

The assessment is advisory in nature and is intended to help homeowners reduce their vulnerability to wildfire.
Implementation of any recommendations is entirely voluntary and at the homeowner's discretion and expense.
The assessment does not guarantee that a property will survive a wildfire event, nor does it guarantee compliance with any specific local, state, or federal fire codes, regulations, or insurance requirements.
I hereby release, waive, discharge, and covenant not to sue Fire Safe Santa Cruz County, its officers, employees, volunteers, agents, and representatives from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, while participating in the assessment or as a result of acting upon any information provided during or after the assessment.
I grant permission for authorized representatives of Fire Safe Santa Cruz County to enter the exterior premises of the address provided for the sole purpose of conducting this assessment.

I have read, understand, and agree to the terms of the Liability Waiver. *

Digital Signature *