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2. Big Lake Police Department Request to Ride With a Police Officer
   Please complete all of the below sections to request to accompany a police officer on a ride along.
4. Name (First - Middle - Last)
5. Date of Birth
7. Address
9. City
10. State
11. Zip Code
13. Phone Number
14. Email Address
16. Reason for Ride Along Request

    1. I am a public safety partner (sworn-probation-dispatch-corrections-other)
    2. I am enrolled in an accredited law enforcement program and a City of Big Lake Resident.
    3. I have a legitimate purpose to request a ride along.
    4. Other (please specify)

    I understand that the following are the only reasons by department policy, which ride along requests will be granted.

17. I Understand the Following Requirements While on Ride Along

    1. All clothing items must be professional in appearance.
    2. General appearance must be professional.
    3. Jewelry and other items must be professional in appearance.
    4. I will follow all instructions being provided by the Officer.
    5. My ride along may be terminated at any time at the discretion of the Officer.
    6. I am not on any medication, or suffering from any medical condition which could impair my ability to function at the direction of the Officer.

    Please check all.
21. Date and Time Requested
22. Do you have a particular officer you are requesting to accompany?
24. Please outline the reasons for your request to accompany a Big Lake Police Officer.
26. To Participate in This Program, I agree to:

    1. I authorize a criminal record check be completed in compliance with the guidelines of this program.
    2. I agree my application will not be signed in the sense of a traditional paper document.
    3. I agree 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.
    4. I agree I may still be required to provide a traditional signature at a later date.
    5. I agree to the below liability release.
28. In consideration of the Big Lake Police Department granting me permission to enter in or upon any premises or vehicles which are under its actual or constructive control, I hereby waive all claims to damage or loss to my person or property which may be caused by any act, or failure to act, of the Big Lake Police Department, its officers, agents or employees. I assume the risk of all dangerous conditions in, upon or about the premises or vehicles and waive any and all specific notice of the existence of such conditions.
30. Electronic Signature
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

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