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2. DRUG SCREEN CONSENT, RELEASE, AND INDEMNITY AGREEMENT
4. I hereby consent to allow Spectrum Health to conduct a pre-employment, random, or reasonable suspicion drug test screen.
6. I further consent to allow the laboratory testing service to make the results of such screen available to the City Of East Grand Rapids.
8. In consideration for such services being rendered on my behalf, I release the laboratory testing service, its officers, agents, and employees, from any claims which I might have due to the results being made available.
10. I consent not to file an action at law or in equity against The City of East Grand Rapids, their respective officers, agents or employees in connection with the results of the screen being made available, and I agree to indemnify and save The City of East Grand Rapids, their respective officers, agents, and employees from all damages, expenses, reasonable attorney's fees, and costs of court which may incur due to the results being made available.
12. Parent/Legal Guardian Signature*
    A signature from a parent and/or legal guardian is required if you are under the age of 18.
13. Date
15. Signature
16. Date
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24. 1. Receive an email copy of this form.
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