Please list the offence, date and location.1.2.3.Are you currently taking medication that could affect your judgment in a stressful situation? [] Yes [ ] NoYou are you an illegal user of marijuana, depressed by a stimulant or a controlled substance? [ ] Yes [ ] No information from Ride Along Please indicate at least 3 dates, including if it is the day, night or both you can get there. This form contains sections in which the applicant recognizes and accepts the potential danger associated with co-travel, and the recognition that the driver is not considered an employee of the City of Chino during the trip, for compensation or other re-relationships. The Carpool Waiver/Request form is signed in the presence of a department staff member who will also sign the form as a witness to the applicant`s signature. Please read the full carpool agreement form. If you have any questions, please come in before your trip. You must sign the same form before your trip. This RELEASE AND Promise also applies to claims that are entirely or partially based on the negligence and/or gross negligence of releases, to the extent permitted by law. . As a condition to participate in a Ride-Along observation session with the University of the Minnesota Police Department (UMDPD), I agree (“Rider”) on waiver and release and stick to the rules below. The Ride-Along Observation Session is voluntary and is not part of my educational program, residency or university job in any way. UMDPD officers may provide first aid and/or receive medical treatment they de consider necessary. I am financially responsible for all costs, regardless of insurance coverage.

Minnesota state laws govern the validity, construction and applicability of this agreement without applying the principles of conflict law. All complaints, lawsuits and complaints about this matter must be filed in the state courts of St. Louis County, Minnesota. If the applicant is under the age of 18, the Carpool Waiver/Request form must also be signed by the applicant`s parent or guardian in the presence of a departmental witness. The one-for-one relationship of the Ride Along program seems to be an ideal way to achieve this goal. (If the participant is under the age of 18, the parent/legal custody is also required) I voluntarily and knowingly assume full responsibility for meeting with all known and unknown risks. On behalf of me, heirs, successors, beneficiaries of the assignment and any other who might claim rights by me or on my behalf, or who may be entitled to damage, to which I am bound or which is based on the damages that the UMDPD, the University of Minnesota, the regents, administrators, employees and any other person associated with the Ride-Along Observation Session (“Releases”) expressly release, compensate and compensate forever for any losses, expenses, expenses or other damages of any kind, including, but not limited to insurance ch├ęgation and legal fees (together and date of Ride-Along/hour: