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Ride-along Request Form

  1. Important: May take up to 14 days for approval and scheduling. Please request dates at least 14 days in advance. Once approved you will be notified by a phone call or an email.

  2. Include State if other than WA

  3. Have you been arrested/convicted of a criminal act in the past two (2) years?*

  4. Please select one of the following to describe yourself:*

  5. Acknowledgement Statement

    Whereas the undersigned has made a voluntary written request for permission to ride as a guest or observer in a Police Department vehicle at a time when such a vehicle is operated and manned by members of said department during the active performance of their official duties as Police Officers; and whereas the undersigned acknowledges that the work and activities of said Police Department are inherently dangerous involving possible risk or injury, damage, expense, or loss to person and property. Now therefore be it understood, that the undersigned (and his parent or guardian if under eighteen) hereby agree that the City, the Police Department, any member of the Police Department, the driver or owner of any automobile owned or operated by or in the service of the City, their sureties, and each of them shall not be held liable or responsible under any circumstances whatsoever by the undersigned, his estate or heirs for any injury, damage, expenses or loss to the person or property of the undersigned, incurred while riding as a guest during the active performance of his official duties as police officer.

  6. Electronic Signature Agreement*

    I declare under penalty and perjury of law that the information I have provided is true and correct to the best of my knowledge. By checking the "I agree" box below, you agree to the above described Acknowledgement Statement and that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature.

  7. Leave This Blank:

  8. This field is not part of the form submission.