SAN ANDREAS STATE POLICE
ADMINISTRATIVE SERVICES BUREAU
PUBLIC AFFAIRS DIVISION
RIDEALONG PROGRAM APPLICATION
ADMINISTRATIVE SERVICES BUREAU
PUBLIC AFFAIRS DIVISION
RIDEALONG PROGRAM APPLICATION
SECTION I — PERSONAL INFORMATION
1. Requestee Name: Adrian Luiz
2. Home Address: Fort Carson apartments
3. Telephone Number(s): 714-5146
4. Date of Birth: 10th of August, 1999
2. Home Address: Fort Carson apartments
3. Telephone Number(s): 714-5146
4. Date of Birth: 10th of August, 1999
SECTION II — REQUEST INFORMATION
5. Availability: Mostly from 6 PM GMT 0 until late hours
6. Reason for Ride-Along Request
6. Reason for Ride-Along Request
- I seek to commit to a Ride Along program as an opportunity to get familiar around the members of this department and maybe find out if there are new policies in general. As well as this may aid to a possible re-instatement.
(( In order to be able to post another reinstatement application I am obliged to show my level of roleplaying and my current knowledge related to being a trooper, so I could use this as an opportunity to RP with other members. ))
SECTION III — LIABILITY WAIVER
7. Background Waiver
I hereby authorize the San Andreas State Police, its troopers, employees, or representatives otherwise, to conduct an intensive background inquiry regarding my character, reputation, and criminal history. I certify that the above submitted information is factual.
I certify that I am physically fit to be taken on a ride-along, and have not been advised otherwise by a qualified medical San Andreas Fire & Rescue Employee
For and in consideration of the undersigned being given the opportunity of observing police operations and functions, by riding in a vehicle operated by a member of the San Andreas State Police, I hereby release and agree to hold harmless the County of Red County, the San Andreas State Police, their employees and agents, both personally, and as agents and employees, from any and all liability for any damage and injury, which I may receive while riding in or upon said motor vehicles and which I may receive while accompanying a San Andreas State Police member, regardless of the cause of such damage or injury, whether through negligence or otherwise.
This release of liability and agreement by me to the County of Red County, the San Andreas State Police, their employees and agents, shall apply to any right of action that might accrue to myself, my heirs and my personal representative. Further, I agree to assume all risks in riding in San Andreas State Police motor vehicles and in accompanying its officers and agents and I am fully aware that personal danger may be involved.
I hereby authorize the San Andreas State Police, its troopers, employees, or representatives otherwise, to conduct an intensive background inquiry regarding my character, reputation, and criminal history. I certify that the above submitted information is factual.
- Signature: A.LUIZ
Date of Signature: 05/JAN/2024
I certify that I am physically fit to be taken on a ride-along, and have not been advised otherwise by a qualified medical San Andreas Fire & Rescue Employee
For and in consideration of the undersigned being given the opportunity of observing police operations and functions, by riding in a vehicle operated by a member of the San Andreas State Police, I hereby release and agree to hold harmless the County of Red County, the San Andreas State Police, their employees and agents, both personally, and as agents and employees, from any and all liability for any damage and injury, which I may receive while riding in or upon said motor vehicles and which I may receive while accompanying a San Andreas State Police member, regardless of the cause of such damage or injury, whether through negligence or otherwise.
This release of liability and agreement by me to the County of Red County, the San Andreas State Police, their employees and agents, shall apply to any right of action that might accrue to myself, my heirs and my personal representative. Further, I agree to assume all risks in riding in San Andreas State Police motor vehicles and in accompanying its officers and agents and I am fully aware that personal danger may be involved.
- Signature: A.LUIZ
Date of Signature: 05/JAN/2024
