Loading...
HomeMy WebLinkAboutFD-78 - Ride-Along Participant Application FD-78 DECLARATION OF ASSUMPTION OF RISK AND RELEASE OF LIABILITY (Read this document in full before signing) I, ____________________________________, the undersigned, declare the following: I am __________ years of age, and not a member of the Fresno Fire Department. I have made a voluntary request to participate in the Ride-Along Program of the Fire Department. During this time, I understand I will accompany any member of the Fire Department to whom I may be assigned during the performance of his/her official duties. These duties may include riding with said officer in a Fire Department vehicle and being present at the scene of a fire or other emergency. I understand the Fire Department will allow me to participate in the Ride-Along Program only upon my agreement of the following conditions: that I assume the risks involved in said participation and that I release and hold harmless the City of Fresno, its officers, agents, and employees from all liability. I understand the duties of the members of the Fire Department are inherently dangerous. I also understand I may be subjected to the risk of death or personal injury or of damage to my property during my participation in the Ride-Along Program. I further understand said risks may arise from, but may not be limited to the following: civil disturbances; explosions; electrocution, the escape of radioactive substances; the effects of wind, rain, fire, and gas; vehicular collision; and air or blood-borne pathogens. I freely and voluntarily assume all of said inherent risks, whether or not they are listed herein. In consideration of my being permitted to participate in the Ride-Along Program, I agree to be bound by all orders, rules, and regulations of the Fresno Fire Department, and to promptly obey all instruction of any Fire Department officer to whom I am assigned. I hereby release the City of Fresno, its officers, agents, and employees from any and all liabilities arising out of my participation in the Ride-Along Program. I have read and understand the contents of this document and sign the same of my own free will. I declare under penalty of perjury that the foregoing is true and correct. Executed this ______ day of _________________________, in Fresno, California. _____________________________________ (Signature of Applicant/Declarant) FRESNO FIRE DEPARTMENT  RIDE-ALONG PARTICIPANT APPLICATION    Name       CA Driver’s License No.        Address        Age       Date of Birth       Cell Phone #       Work #          Do you have a criminal record?  Yes  No If yes, please explain:               If you have a criminal record, this may be cause for your ride-along application to be denied.    Health Information (List any known health problems.)               In Case of Emergency notify: Name       Relationship        Address       Cell Phone #       Work #          Are you related to a member of the Fresno Fire Department?  Yes  No    If yes, employee name  Relationship        Are you a member of another public safety agency?  Yes  No    If yes, organization name       Job Title        Name of Supervisor       Phone #        Yes to either of these questions may bypass the need for a background investigation for approval.  Signature of Applicant          TO BE COMPLETED BY AUTHORIZING OFFICER Investigator’s Initials        Approved  Denied  BC Name:  Station Assigned       Date Assigned       Time Assigned         Reason for Denial                By:         FRESNO FIRE DEPARTMENT RIDE-ALONG PROGRAM RIDE-ALONG PROGRAM Have you ever wondered what it would be like to be a firefighter? Are you interested in learning more about how your fire department operates? Are you considering a career in the fire service? If you have ever asked yourself any of these questions, the Fresno Fire Department’s Ride-Along Program may be for you. WHAT IS THE RIDE-ALONG PROGRAM? The Fresno Fire Department has made it possible for city residents to have an exciting, firsthand experience on what it is like to be a firefighter. The program allows interested persons the chance to learn how the Fresno Fire Department operates. Participants spend the day at a fire station, respond to emergency calls on the fire apparatus, and accompany firefighters in their daily activities. HOW DOES THE RIDE-ALONG PROGRAM WORK? After completing a Ride-Along Participant Application form, the Investigations Unit will conduct a background check and an interview with the interested participant. Rules will be discussed and a Release of Liability form completed. Upon acceptance to the Ride-Along Program, an applicant will choose a date, time, and the fire station at which he/she wishes to ride-along. All stations, with the exception of the Department’s Aircraft Rescue Firefighting Team, are available for a ride-along. Participants may ride-along for 2-14 hours, between the hours of 8 a.m. and 10 p.m. Appropriate dress is required (casual dress with collared shirt), and participants should bring money for meals and snacks. In addition, participants should bring a good attitude, lots of questions, and be ready for a unique experience.  GENERAL GUIDELINES The following are general guidelines, although some exceptions may be granted at a chief officer’s discretion: The program is available to residents residing within the Department’s geographical response area. Participants must be at least 18 years old or 16 with parent/guardian consent. Ride-alongs are limited to once per year. RULES OF CONDUCT All participants are required to sign a Declaration of Assumption of Risk and Release of Liability section. A criminal record may be cause for a ride-along application to be denied. A participant will be briefed on rules and expectations by the company officer of the station where participant will be doing the ride-along. Due to Constitutional “right to privacy” and HIPAA laws, a participant will not be allowed to electronically record any responding emergency calls. Firefighters have an inherently dangerous job, and the safety of the ride-along participant is paramount. If the company officer feels the situation at hand is not conducive to the safety of the participant, he/she may be asked to stay in the vehicle, or arrangements made to have the participant transported from the scene by another member of the Department. While Department members will look out for the participant’s safety, the ultimate responsibility for staying safe lies with the participant. CONTACT INFORMATION For an application, visit your nearest Fresno Fire Department station or headquarters located at 911 H Street (across from Chukchansi Park). Application must be turned in at least ten days prior to the desired ride-along date.