Ride Along Program Authorization / Release of Liability (Gila River Police Department)

Date Completed(Required)

The Gila River Police Department is pleased you have chosen to participate in the Ride Along Program. Due to the nature of police work however there are certain risks and liabilities that the rider must be aware of.

In addition to the assumed risks the rider must agree to the following set of guidelines:(Required)

1. Riders are expected to present a neat and clean appearance.

2. At no time will riders interfere in any way with the actions of the police officer or officers while engaged in their official duties.

3. Riders are to remain in the patrol unit while the police officers are on a call. However, on certain calls, and at the officer’s discretion, the rider may observe outside of the patrol unit if the officer allows.

4. No attempt by the rider will be made to assist the officer(s) on a call unless specifically directed by the officer or officers at the call.

5. Should you witness certain events there is the possibility that you will be subpoenaed to court to serve as a witness for the Gila River Indian Community.

6. No firearms or weapons are to be in the possession of any rider while participating in the Ride Along Program, unless the rider is a sworn police officer (and Prior Approval has been granted by the Bureau Commander or Lieutenant.)

7. Police Officers can be and often are assigned duties which involve dangerous and serious risks. Therefore, the officer which you are assigned will not avoid or disregard his/her duties.

8. Due to the confidential nature of certain calls the rider agrees not to discuss with anyone any information regarding incidents that the rider may be a witness of, unless directed to do so in a court of law.

Gila River Police Department Ride Along Program Authorization / Release of Liability

In consideration of the above and any other type of risk or danger not stated, I(Required)

do hereby release the Gila River Police Department; it’s officers, public officials, agents, servants, employees and the Gila River Indian Community from any and all liability. To include: claims, demands, actions and causes of actions which I(Required)

may hereafter have on account of any and all injuries and damage to me or my property, or my death arising out of, or related to any happenings or occurrence while accompanying any office of the Gila River Police Department.

I,(Required)

also promise to release and covenant not to sue the Gila River Police Department, and said persons and agree to forever hold them and each of them harmless from any such liability, claims, demands, actions or cause of action. The terms of hereof shall be in full force and effective on the date of hereof and on any other occasion hereafter when I accompany and Gila River Police Department Officer.

I,(Required)

have read and understand the conditions and provisions of the Ride Along Program as stated above and hereby voluntarily assume all risks of loss damage or injury to me or my property to include serious bodily injury or even death. This release and agreement shall be binding upon me and my heirs, executors, administrators, personal representatives and assigns and shall insure the benefit of said city, agents, public officials and person herein and their heirs, executors, administrators, personal representatives, assigns and successors in office.

Name(Required)

Last First Middle

Signature(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Telephone #(Required)

SSN #(Required)

Dated:(Required)

Day

Month

Year

DOB(Required)

Requested Date /(Shift) of Ride-Along

Day

Month

Year

Shift

Requested Officer (if applicable)

***Once cleared, you will be contacted of your approval***