
Ride Along Application Format
1. Personal Information:
- 1.1 First Name: Anna
1.2 Middle Name: N/A
1.3 Last Name: Seong
- 1.4 Address: 2362 Bridge Street - Floor 2, Room 3
1.5 City: Los Santos
1.6 State: San Andreas
- 1.7 Phone Number: 86127857
1.8 Date Of Birth: 15/OCT/2001
1.9 Gender:- [-] Male
[X] Female
[-] Other
- [-] Male
- 1.10 Ethnic Group / Race (mark only one)
- [-] Black
[-] Hispanic
[X] Asian/Pacific Islander
[-] Caucasian
[-] American Indian
[-] Filipino
[-] Middle Eastern
- [-] Black
2. Ride Along Details
- 2.1 Type of a Ride Along you're interested in:
- [X] Field Ride Along
[-] Aerial Ride Along
[-] Both
- [X] Field Ride Along
- 2.2 What is the reasoning behind your ride along?: Wishing to get a closer look at the day-to-day experience of Lifeguards.
2.3 Are you interested in joining the LSFD?: Potentially, depending on the outcome of a few ride-alongs.
2.4 Do you have any previous ride along experience?: No.
3. Personal Liability Waiver & Release Form
- 3.0 - Personal Liability Waiver & Release Form:
As a condition precedent to being permitted to ride as a Ride-Along with the Los Santos Fire Department, I the undersigned, waive any claim I may have against the Los Santos Fire Department for any loss of life, bodily injury, property damage or any other claim whatsoever that I may sustain as a result of my Ride Along. I further agree that this waiver of liability by me is binding on my legal representatives, heirs, and successors, and shall have the same legal effect as I have agreed to herein. I also understand that the Los Santos Fire Department may waive my right to a Ride Along for any reason and at any time, especially should I be in violation of the regulations set. Having that said, I adhere to the regulations set by the Los Santos Fire Department.
- 3.1 Full Name (Sign): Anna Seong
3.2 Full Name (Print): ANNA SEONG
3.3 DATE: 08/SEP/2022
4. Legal Guardian / Parental Consent
- 4.0 To be filled out by a parent/legal guardian. Leave blank if you are over the age of 18.
4.1 First Name:
4.2 Last Name:
4.3 Date of Birth:
- 4.4 Place of Residency-
4.4.1 Address:
4.4.2 City:
4.4.3 State:
- 4.5 Relationship to Applicant
- [-] Mother
[-] Father
[-]Other: (specify)
- [-] Mother
- 4.6 Do you, as a legal guardian / parent give consent for the applicant to take part in LSFD's Ride Along program?
- [-] Yes
[-] No
- [-] Yes