Ride Along Request Form - San Diego Police Department
Download a blank fillable Ride Along Request Form - San Diego Police Department in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Ride Along Request Form - San Diego Police Department with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2SAN DIEGO POLICE DEPARTMENT
RIDE ALONG REQUEST FORM
Date Received
Home Phone
Work Phone
Name
DOB
Home Address
STREET
CITY/STATE
ZIP
Business Address
STREET
CITY/STATE
ZIP
Driver’s Lic/ID
Occupation
SS#
Division Assigned
Shift Desired
First Ride Along: Y / N
Reason
Request Received by
AUTHORIZATION FOR MEDICAL TREATMENT
I understand and agree that the City of San Diego does not, and will not, provide medical coverage for
me/my child, and I WILL BE RESPONSIBLE FOR ANY MEDICAL COSTS INCURRED as a
result of participation in the activity. I give authorization to a physician or surgeon, licensed under the
provisions of the Medical Practice Act, to give me /my child, ________________________________,
care and/or emergency medical treatment when necessary.
________________________________
______________________________
_______
Participant or Parent (Print Name)
Signature
Date
COORDINATOR USE
Routed to _________________________
Date _______________
Watch ___________
Ride Along File Checked: Y / N
Age Waiver: Y / N
Captain’s Signature _____________________________________
Captain Waiver: Y / N
Records Check Results ____________________Warrant Check Results ___________________
SUPERVISOR USE
Officer Assigned ____________________ If Ride Along Denied, Why?____________________
OFFICER USE
Officer Assigned __________________ Contact Date __________ Date of Ride Along _______
Obtain ID/Log Info. __________ Complete waiver _______ Advise Communications _______
Advise of Witness Obligation ___________
Advise of Safety Precautions ________
Officer’s Comments Attached: Y / N
Page 1 of 2
Police Legal (PEF) 6/14/2010
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal