FFD Ride-Along Application

Hello!

Thank you for your interest in participating in a ride-along with the Fresno Fire Department. All interested parties are required to complete the following application before participating in a ride-along. Incomplete and/or inaccurate applications may delay, or result in a denial of, your request. Please review the Rules of Conduct below and initial that you agree to the terms of the Fresno Fire Department before submitting your application.

We look forward to having you!

RULES OF CONDUCT:

All participants are required to sign a Declaration of Assumption of Risk, Release of Liability, Photo Release, and submit to a Background Check.
A criminal record may be cause for a ride-along application to be denied.
Participants will be further briefed on rules and expectations by the company officer of the assigned station on the day of the ride-along.
Due to Constitutional “right to privacy” and HIPAA laws, participants are not allowed to electronically record (take photo, video, or audio) at any time during the response to an emergency call.
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.
NOTE: The Fresno Fire Department does not allow any persons actively engaged in a Fire Department recruitment process (for any position) to participate in a ride-along.

I agree to the Rules of Conduct and certify that I am not actively engaged in a recruitment process for any position within the Fresno Fire Department

APPLICANT QUESTIONS:

First Name

Last Name

License Number

Age

Date

Cell Phone Number

Date of Birth

Address

City

State/Province

Zip/Postal

Why do you desire to participate in a ride-along?

What type of ride-along are you looking for? What type of ride-along are you looking for?

What is your availability for a ride-a-long?

Do you have a station or area that your prefer?

Special Requests

I would like to be assigned to a shift with a female crew member

I would like to ride-along at a busier station

OtherOther

Are you related to a member of the Fresno Fire Department?

Member's Name

Relationship

Are you a member of a public safety agency?

Agency Name

Position

Supervisor

Phone

Do you have a criminal record?

Please Explain

Do you have any health information we need to know about?

Known Health Issues...

In Case of Emergency who should we notify?

Relationship

Phone

Parent/Guardian information, if minor is unaccompanied

Parent/Guardian Relationship

Parent/Guardian Phone

DECLARATION OF ASSUMPTION OF RISK AND RELEASE OF LIABILITY:

(Read this document in full before signing)

Declaration Confirmation

the undersigned, declare the following: I am 16 years of age or older, 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, 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 selected day in Fresno, California.

Signature of Applicant/Declarant

Clear

Signature of Parent/Guardian, if under 18 years old

Clear

Please review the Additional Information below and initial that you understand and acknowledge.

ADDITIONAL INFORMATION:

Ride-alongs are limited to once per year, per participant.
Appropriate dress is required (closed toed shoes, pants).
Meals: All food and meals at fire stations is the responsibility of crews–the City does not pay for any portion. Therefore, please come ready to enjoy an awesome meal, but plan to bring cash to contribute to the cost.

If you are human, leave this field blank.