Ventura County Sheriff'S Office Ride-Along Waiver Form (Page 4 of 4) in pdf

Ventura County Sheriff'S Office Ride-Along Waiver Form Page 4

Police Services Ride-Along Check List

General Information

(To be completed by applicant)

Name of Ride-Along_____________________________________________________

(Please Print)

LAST

FIRST

Other Names/Aliases __________________________________DOB ______________

Home Address__________________________________________________________

Home Phone ___________________ Occupation______________________________

(If student: list school/grade)

Driver’s License # and State_______________________________________________

In Case of Emergency Notify

(To be completed by applicant)

Name Address Phone Relation

Family Doctor or Medical Services Requested by Rider if needed:

______________________________________________________________________

Records Check

(To be completed by Records Bureau)

DMV ______________ Warrants __________________Records _________________

FI Cards _____________________ Previous Ride-Alongs _______________________

Date Check Completed _____________________Records Clerk __________________

Approval / Assignment

(To be completed by Station Manager or Station Sergeant)

Assigned to:____________________________________________________________

Deputy

Area

Shift

Date

Approved by: ___________________________________________________________

Name

Rank

Date

Ride-Along Completed: ___________________________________________________

Deputy’s Signature

Ventura County Sheriff'S Office Ride-Along Waiver Form Page 4