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Project Lifesaver®

Standard Operating Procedures

1. Enrollment

Transmitters will be placed with clients only at the request of a legally responsible party, i.e.:

1. Spouse        
2. Son or daughter, in the absence of a spouse
3. Family member having legal, primary caregiver responsibility
4. Father or Mother, if client is a minor

• In the event there is no spouse and there is disagreement on placement, no placement will be done until requested by the family member having legal authority via power of attorney or court order naming him/her as the responsible caregiver. This will also apply in the case of minors with no parent available.
• Caregivers will be provided with instructions and emergency contact phone numbers 
• Caregivers will be provided a tester and given instructions on its use and the procedures to test the transmitter daily and record the testing on the monthly inspection sheet.
• The caregivers will be given a contract and the terms and agreements will be explained.  The contract must be signed and filed at the Administration Office. 
• Payment for the program is $20 a month.  The first payment is due on the date the bracelet is placed. Subsequent Checks should be made payable to the Pilot Club of Greensboro and given to the Pilot Member who changes the battery every other month. 
   

Project Lifesaver®

Client Profile

Personal Data Questionnaire

In addition to being an application, this form also is designed for Custodial Care Givers to provide, in advance, certain information that will be useful to Search Teams, should the need arise.  Providing the information in advance of the need will allow Search Management Personnel the necessary information to establish a more effective search response.

or

Contact 1

Contact 2

List any medication using correct name of drug and dosage being taken:  

If Alzheimer’s disease has been diagnosed, Answer the following:

Handbag, Purse or Wallet:

Most recent former address:

There is a monthly charge of $20.00.  This fee goes toward the maintenance of equipment, replacement batteries and the purchase of additional equipment for use in the ongoing need of the program.  Neither the Sheriff’s Office nor the Pilot Club makes a profit from the program.  This fee may be paid monthly, quarterly or yearly.

Monthly      
Fee of $40 due at time of placement . . . and every two months thereafter as battery is changed

Quarterly    
Fee of $60.00 due at the time of placement . . . three months from the day of bracelet placement . . . and every three months thereafter

Yearly    
Fee of $240.00 due at time of placement and on the yearly anniversary date of placement thereafter

The Fee, payable based upon your choice, is due at the time of bracelet placement.  
Subsequent payments may be mailed or given to your Pilot Team Member who changes the bracelet battery.  Reminder bills will not be sent.

Checks should be made payable to The Pilot Club of Greensboro.

If you feel that you are unable to pay the $20.00 per month fee, please let your Pilot contact know.

I understand our obligation to pay and agree to pay the fee as noted above.

Sheriff’s Office

Project Lifesaver®

ACKNOWLEDGMENT & WAIVER OF LIABILITY

In consideration of Applicant’s enrollment in the Guilford County Sheriff’s Office (“G.C.S.O.”) Project Lifesaver Program, on behalf of myself and Applicant, I acknowledge and represent as follows:

1. I represent and warrant that I have full power and authority as the duly authorized legal representative of the Applicant named below to register him/her and to enter this Acknowledgment & Waiver of Liability on his/her behalf.  I will supply documentation of my legal authority to act for Applicant upon request.
2. I acknowledge that any information that I have provided or will provide in connection with Project Lifesaver is true and accurate to the best of my knowledge, given voluntarily, and may be collected, used, and disclosed for the purposes of G.C.S.O. Project Lifesaver. 
3. I understand that enrollment of Applicant in G.C.S.O. Project Lifesaver does not replace the need for constant supervised care of the person.  I am, and remain, primarily responsible for supervised care and take full responsibility for protecting Applicant from wandering.  I also understand that I, or a family member, must be present in the home with Applicant at all times.
4. I understand that Project Lifesaver equipment is designed to be an additional aid to help locate a missing person but that there is no warranty, representation or guarantee that a person will be found because they are wearing a Project Lifesaver bracelet.  Project Lifesaver equipment is designed to provide emergency personnel with an additional technology in attempting to locate Applicant.  I acknowledge that this is an experimental program for aiding in the search and rescue of persons suffering from diminished mental capacity or other disability.  I understand that while Project Lifesaver is an electronic tracking device that assists in locating persons who wear the bracelet device, there may be times or circumstances when individuals are not located even while wearing the transmitter bracelet.
5. In order for Project Lifesaver to work, I have a responsibility to obey the instructions of the Program, follow all training, and make sure that Applicant is wearing the Project Lifesaver transmitter bracelet.  If the bracelet has been removed or is defective, I will call G.C.S.O. Project Lifesaver immediately.
6. When I notice that the Applicant enrolled has wandered off, I must immediately call the emergency number supplied by G.C.S.O. Project Lifesaver and report Applicant as a missing person.  I understand and acknowledge that the Project Lifesaver device cannot predict or report that Applicant has wandered. 
7. For myself, Applicant, our heirs, administrators and assigns, I release and hold harmless Project Lifesaver, Inc., its associated law enforcement, fire, and rescue agencies, Guilford County, the Guilford County Sheriff’s Office, Sheriff BJ Barnes, the Pilot Club of Greensboro, Inc., and every officer, employee, agent, volunteer, successor, or representative of any of the forgoing (collectively “Releasees”) from all claims, liability, causes of action, loss or damages of any kind arising in whole or in part from Applicant’s participation in Project Lifesaver, including but not limited to those arising in whole or in part from any failure to locate or delay in locating Applicant. Further, without limiting the forgoing, I acknowledge that Releasees have assumed no duties to me or to Applicant in connection with Project Lifesaver and that any duties that Releasees may have are solely those that they may have to the public generally.
8. I understand that all information I have provided or may provide in connection with Project Lifesaver may be shared among law enforcement, fire, rescue, and other necessary agencies.  I further understand that none of the information I have provided or will provide in the future can be considered confidential, protected, or private when used for the purposes of the G.C.S.O. Project Lifesaver Program.
9. I waive any rights to the confidentiality of Applicant’s medical records when sought or disclosed for purposes of Project Lifesaver by any Releasee.  I confirm that I have the authority by which to waive such rights.    
10. I understand that if I fail to use the tester device at least once per day and record the results on the supplied test result monthly inspection sheet, or if I fail to notify G.C.S.O. Project Lifesaver immediately when I discover Applicant missing, or if I fail to notify G.C.S.O. Project Lifesaver if I test the transmitter device and find no signal indication, or if the Applicant refuses to wear or removes the device 3 (three) times, then Applicant will likely be  removed from the program.  
11. I acknowledge that Releasees are not required to continue Applicant’s participation in Project Lifesaver and may terminate Applicant’s participation at any time. I understand that all equipment remains the property of G.C.S.O. Project Lifesaver and that when no longer being used by the Applicant to or upon Applicant’s ceasing to be a participant in Project Lifesaver, I shall return all equipment undamaged to the G.C.S.O. and I shall remain liable for any loss or damage to all such equipment and for the replacement cost of all such equipment until returned to the G.C.S.O.