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1 Puyallup Police Department Ride Along Application ATTENTION Applicant MUST be 18 years old or older. (Applicants that are 16-17 years old may be approved for a ride along in certain circumstances with command staff approval). Applicant must live in, own a business in, or attend school in the city limits of Puyallup. Ride-Alongs will generally be for four hours. Unsponsored applicants are limited to one ride along unless approved by police department command staff. Date of Request: Full Legal Name: Date of Birth: Address: Phone: Employer or School: Phone: Medical Problems or Physical Disabilities: Check Appropriate Commissioned Officer City Employee City Resident CSO Dispatcher Police Department Job Applicant Media Student Job Shadow Family Member Other: Sponsoring Officer (if you have one): Requested Date to Ride: Emergency Contact: Phone: PROHIBITED CRIMES FOR RIDE ALONGS 1.Have you ever been arrested or convicted of any felony offense? Yes No (If you are unsure if a crime is a felony please list in space provided below and a determination will be made). 2. Have you ever been arrested or convicted in a misdemeanor crime? Yes No If yes please explain ---PAGE BREAK--- 2 Waiver and Guidelines for a Puyallup Police Ride Along 1. The rider will obey all commands given by officers during the ride along. 2. The rider will remain within the patrol vehicle unless otherwise instructed by the officer. 3. The rider has read the Civilian Ride-Along program information sheet and understands and agrees to the information and restrictions placed on a civilian rider. 4. The rider has been informed that if the officer is requested to respond to certain calls for service the rider may be let out prior to arrival at the call. The rider is responsible for his/her own transportation from the drop off location. 5. The rider will not engage in any conversation with violators or prisoners other than general courtesies. 6. The rider will not possess any audio or video recording equipment. The only exception is with prior approval from command staff. Riders will not post anything on any social media sites about their ride or what they observed during the ride. 7. The rider will not possess weapons of any kind to include but not limited to knives, guns and chemical sprays unless they are a commissioned law enforcement officer. 8. The rider will not enter any private residence with the officer they are riding with unless the officer first receives consent from the homeowner or person responsible for the residence at the time of the incident. The applicant does hereby request from the Puyallup Police Department to ride as an observer only in an authorized Puyallup Police Department vehicle. This observation is for the purpose of an educational benefit. The applicant fully realizes and appreciates the basic nature of law enforcement work and possibility that situations will arise which might place the applicant or expose the applicant to extreme danger. I recognize and accept all risks associated with being a passenger in a Puyallup Police vehicle during a ride along. I fully accept the risk of harm to myself including, but not limited to physical and mental injury and death. I hereby agree to release and hold harmless the City of Puyallup and its officials and employees from any cause of action, claim, or liability resulting from physical or mental injury or death that might occur during the ride along and I assume all such associated risk. The applicant may hear stories or see documents that may not be of public record. The purpose of the criminal history background check is to ensure the observer has not had any negative contacts with the police as well as has no criminal history. By submitting and signing this application, the applicant voluntarily and intelligently acknowledges and consents to the Puyallup Police Department conducting a criminal history background check that will include, but may not be limited to, arrest and conviction data. The information derived from the criminal history background check will be kept confidential to the extent permitted by law. I HAVE READ THIS WAIVER AND RELEASE OF LAIBILITY AND FULLY UNDERSTAND ITS TERMS. I UNDERSTAND I AM RELEASING SUBSTANTIAL RIGHTS BY SIGNING THIS WAIVER AND RELEASE OF LIABILITY. I VOLUNTARILY AND INTELLIGENTLY SIGN THIS WAIVER AND RELEASE OF LIABILITY AND CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT I HAVE THRUTHFULLY AND ACCURATELY PROVIDED THE INFORMATION CONTAINED IN THIS APPLICATION. Signature: Date: Parent Name (If applicant under 18)(please print): Parent Signature: Date: *Please submit a copy of your driver's license with application. ---PAGE BREAK--- 3 Pre-Ride Screening Must be completed prior to ride-along Photo ID Copied and Attached No Record Background Completed Record Found and Attached Completed By: Date: Approved Denied (reason): By: Date and Time of Ride: Officer: Sergeant Notes: TO BE FILLED OUT BY POLICE DEPARTMENT PERSONNEL ONLY ---PAGE BREAK--- 4 Puyallup Police Department Civilian Ride Along Program · The Puyallup Police Department provides citizens the opportunity to ride along on a shift with officers during a normal patrol shift. Applicant must live in, own a business in or attend school in the city limits of Puyallup. · Unsponsored applicants are limited to one ride along unless approved by command staff. · Applicant MUST be at least 18 years old. (Applicants who are 16-17 years old may be approved for ride alongs with command staff approval in certain circumstances (Job shadow requests are completed by our school resource officer and will occur during school hours. · The Puyallup Police Department reserves the unilateral and sole right and discretion to not approve any applicant from participating in the ride along program with or without cause. · Civilian riders will be required to sign a waiver of liability and acknowledge that no liability, property damage, or any other insurance coverage will be extended to them while they are riding with the Puyallup Police Department. As a civilian rider you must understand that you may be exposed to communicable diseases or physical harm. This includes, but is not limited to, physical or mental injuries as a result of a vehicle accident or from a violent encounter. · Applications for the ride along program must be completed and turned into the police department at least three weeks prior to the first desired ride along shift. · No person will be allowed to ride with an officer if they appear to be under the influence of alcohol and/or drugs or have the smell of intoxicants on his/her breath. · The ride along is limited to a 4-hour period but may be ended sooner depending on current calls or at the unilateral and sole discretion of the shift supervisor. Civilian riders must have adequate funds available to pay for a taxi or other for-hire transportation at any time during the ride along as it may be necessary for the applicant to use such transportation to the Puyallup Police Department to retrieve their vehicle or a ride to their residence from anywhere within the City limits. · Riders will not have in their possession any video or audible recording devices. Prior approval from command staff is required if any of this type of equipment is to be used. · Riders will not post anything on any social media sites about their ride or what they observed during the ride. · Riders are required to wear appropriate clothing during the ride. No shorts, sweats or clothing that is torn will be allowed. No hats or clothing with police emblems or similar type emblems will be allowed. Riders are further advised that you may be required to stand outside for an extended period of time and appropriate coats for the weather will be needed. · Civilian riders will not carry weapons of any kind to include but not limited to knives, handguns or chemicals sprays. The only exception to this is a commissioned law enforcement officer from another agency is authorized to be armed. · Riders acknowledge and understand that they may witness events during the course of a ride along that will require that they testify in court or be interviewed as a witness in an investigation. · During a normal ride along you may be exposed to very graphic scenes, profanity, and other unusual/uncomfortable situations. If you are easily offended you may want to reconsider your application for the program. · During the course of a normal patrol shift you will be exposed to confidential and sensitive materials. Anything or anyone you observe during the course of the ride is confidential and is not to be discussed with anyone other than Puyallup Police Department employees. If approved for a ride along YOU MUST BRING THIS FORM WITH YOU AT THE TIME OF THE RIDE ALONG. I certify under penalty of perjury under the laws of the State of Washington, that I have reviewed this document in its entirety that I do not have any questions or reservations regarding the foregoing requirements, and that I voluntarily and intelligently understand and acknowledge the foregoing requirements for a ride along. Applicant Signature Date Print Name Parent or Legal Guardian (if applicant is under 18 years old) Date Print Name I have confirmed that the ride along applicant has read and understands the above requirements. Officer Signature Date Print Name