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)

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

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.
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.
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)
Address(Required)
Dated:(Required)
Day
Month
Year
DOB(Required)
Requested Date /(Shift) of Ride-Along
Day
Month
Year
Shift

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