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: Aveline Raine
2. Home Address: 5 Montgomery View
3. Telephone Number(s): ((Provided Privately))
4. Date of Birth: Feb 14, 2000
2. Home Address: 5 Montgomery View
3. Telephone Number(s): ((Provided Privately))
4. Date of Birth: Feb 14, 2000
SECTION II — REQUEST INFORMATION
5. Availability: Flexible depending on my particular situation, as described below.
6. Reason for Ride-Along Request
6. Reason for Ride-Along Request
- I reside with a Lieutenant in the department and have informally accompanied her and many of her colleagues as the need to do so arised through our particular situation. I have, as such, developed an interest in learning more about the work of the department meanwhile pursuing my own personal development as a thoughtful, mature and responsible member of the community. I submit this application to provide the formal certification for our previous and continued engagements as required.
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. Raine
Date of Signature: 07 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. Raine
Date of Signature: 07 Jan 2024
