Fill and Sign the Hold Harmless 497332483 Form

Release, Waiver and Hold Harmless Agreement regarding Test Drive Dealer Name: _____________________________________ Salesperson’s Name ________________________________ Salesperson’s ID: _________________ Customer’s Name: _________________________________________ Customer’s Driver License No. ____________________________________ Address: _____________________________________________ Home Phone: _____________________ Work Phone: ________________________ Cell Phone: ___________________________________ Date of this Agreement: ____________________________ Test Drive Start Date _________________ Test Drive End Date _________________ Test Drive Start Time ______________________ Test Drive End Time _____________ Stock# _________________ Tag # ____________________ Customer Photo ID: _______________________________ Vehicle Identification Number ______________________________ Notice – Test Drive Agreement Test Drive Agreement This Test Drive Agreement (the Agreement ) is made on the _______________ (date) , between ________________ (Name of Customer) of _________________________________ ___________________________________ (street address, city, state, zip code) , referred to herein as Customer , and _____________________ (Name of Dealer) , a corporation organized and existing under the laws of the state of ______________, with its principal office located at ____________________________________________________________ (street address, city, state, zip code) , referred to herein as Dealer . Whereas, Customer desires to evaluate the vehicle with stock, tag and vehicle identification numbers as listed above (the Vehicle ); and Whereas, Dealer consents to such evaluation in accordance with the terms of this Agreement; Now, therefore, for and in consideration of being allowed to test drive the Vehicle, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, Customer agrees to the following: 1. Customer shall only drive the Vehicle from the Test Drive Start Time on the Test Drive Start Date until the Test Drive End Time on the Test Drive End Date defined above. 2. Customer shall be responsible for any and all liabilities (civil, criminal or otherwise) incurred while driving the Vehicle. 3. Customer shall not use the Vehicle for any purpose deemed illicit or illegal, or for any purpose which is otherwise in violation of federal, state or local laws. 4. Customer does hereby release Dealer, Dealer’s employees, successors, and assigns (collectively Releasees) from all liability for property damages and/or for any physical injury or death (accidental or otherwise) that results, directly or indirectly from the Test Drive. Customer further agrees to indemnify, save and hold Releasees harmless from any loss, liability, attorneys ’ fees, damage, or costs that Releasees (or any of them) may incur arising out of or related to the Test Drive , whether caused by the negligence of the Releasees or otherwise. 5. This Agreement shall in no way imply the transfer of ownership of the Vehicle from Dealer to Customer. 6. Failure to comply with the terms of this Agreement, including failure to return the Vehicle at or before the Test Drive End Time on the Test Drive End Date, may result in criminal and/or civil proceedings being brought against Customer. WITNESS our signatures as of the day and date first above stated. ________________________ (Name of Dealer) ________________________ By: _____________________________ (P rinted Name of Customer) ___________________________ ________________________ (P rinted Name & Office in Corporation) (Signature of Customer) ___________________________ (Signature of Officer)