2. Last Name:*
3. First Name:*
4. Middle Name:
6. Date of Birth:*
   Date of Birth:
8. Address*
10. City*
11. State*
12. Zip Code*
14. Telephone Number:*
16. Your Desired Date of Ride Along (Choice 1):*
18. Your Desired Date of Ride Along (Choice 2):*
20. Your Desired Date of Ride Along (Choice 3):*
22. Desired Shift:*
    -- Select One --7AM - 1PM8AM - 2PM9AM - 3PM10AM - 4PM11AM - 5PM12PM - 6PM1PM - 7PM7PM - 1AM 8PM - 2AM9PM - 3AM
24. Preferred Police Officer (If Applicable):
26. Affiliation (please check all that apply):

    1. Explorer/Scout
    2. Neighborhood Representative
    3. Wheaton Resident
    4. Other
28. Describe Other:
30. Are you an Immediate Friend/Spouse/Family Member of a Wheaton Police Officer?*

    1. Yes
    2. No
32. Officer’s Name:
34. Are you a Spouse/Family Member/Friend of a City of Wheaton Employee?*

    1. Yes
    2. No
36. Employee's Name
38. Are you a Criminal Justice Student?*

    1. Yes
    2. No
40. Name of Institution:
42. Have you participated in the Wheaton Police Department Ride-Along Program within the past 12 months?*

    1. Yes
    2. No
44. If yes, what were the date(s)?
46. Have you ever been convicted of a misdemeanor or felony crime?*

    1. Yes
    2. No
48. If yes, please explain:

50. EMERGENCY CONTACT INFORMATION

52. Person #1 to be notified in case of any emergency

54. Name:*
56. Address:*
58. Telephone Number:*

60. Person #2 to be notified in case of any emergency

62. Name:
64. Address:
66. Telephone Number:
68. What is the reason for your ride-along request? (Class project/paper, school/class assignment, interested citizen, interest in a law enforcement career, etc).*

70. WHEATON POLICE DEPARTMENT RIDE-ALONG RULES AND REGULATIONS

    The Wheaton Police Department’s Ride-Along Program is a public service extended to persons who are interested in observing a police officer, their duties, and how they interact with the community. The department requires specific information in order to ensure that police operations and community services are not adversely impacted.

    POLICE WORK IS INHERENTLY DANGEROUS DUE TO MANY FACTORS, INCLUDING THE POSSIBILITY OF HIGH-SPEED PURSUITS, ARMED SUSPECTS, AND POTENTIAL EMOTIONAL TRAUMA. THIS IS STRICTLY A VOLUNTARY PROGRAM AND YOUR PARTICIPATION IN THIS ACTIVITY IS FULLY TAKEN WITH KNOWLEDGE OF THE POTENTIAL DANGER INVOLVED AND YOUR WILLINGNESS TO ASSUME FULL RESPONSIBILITY FOR, AND RISK OF, BODILY INJURY, DEATH, OR PROPERTY DAMAGE DUE TO THE NEGLIGENCE OF THE CITY OR OTHERWISE RESULTING FROM ANY ASPECT OF YOUR VOLUNTARY PARTICIPATION IN THE WHEATON POLICE DEPARTMENT RIDE-ALONG PROGRAM. 

72. #1. I understand that my participation is at the sole discretion of the Wheaton Police Department to accept or deny any person’s participation in the Ride-Along Program. My participation in the Ride-Along program is a privilege and not a right.

74. 1. I agree with rule and regulation #1 above

76. #2. I understand that failure to abide by all the requirements in this application and waiver will result in immediate termination of the Ride-Along and may prohibit me from being considered for future Ride-Along.

78. 1. I agree with rule and regulation #2 above.

80. #3. I acknowledge that I must wear either business or neat casual attire. I understand that if, in the opinion of the Wheaton Police Department, my attire is not suitable, I may be denied participation in the Ride-Along Program.

82. 1. I agree with rule and regulation #3 above.

84. #4. As a ride-along participant, I acknowledge that I will not be permitted to carry weapons of any kind, unless I am a certified/licensed police officer and present my professional credentials.

86. 1. I agree with rule and regulation #4 above.

88. #5. I understand that my application may be approved or denied based upon the following: Operational demands, available personnel, safety-related issues, voluntary background investigation.

90. 1. I agree with rule and regulation #5 above.

92. #6. All ride-along participants must complete a RELEASE OF ALL LIABILITIES. Participants must be at least fourteen years of age and have a RELEASE OF ALL LIABILITIES and PARENTAL CONSENT signed by a parent. Refusal to complete this form, or false statements of any nature on this form will disqualify me from participation in the program.

94. 1. I agree with rule and regulation #6 above.

96. #7. The ride-along application must be submitted two (2) weeks prior to the first requested date of participation. At the Deputy Chief of Operations discretion, exceptions may be made for special situations requiring shorter notice, if other procedures are followed. Refusal to complete this form or any false statements provided on this form will immediately disqualify the applicant from participation.

98. 1. I agree with rule and regulation #7 above.

100. #8. Participants must obey the orders and instructions given by the officer to whom they are assigned. They will receive a safety briefing from the officer to whom they have been assigned. They will be given an opportunity to ask questions that may clarify any of those requirements. 

102. 1. I agree with rule and regulation #8 above.

104. #9. I understand that I am to comply with and obey all commands of the officer at all times during the ride-along. I will not take any action(s) that will inhibit the actions of the officer or that will jeopardize the safety of myself and/or the officers. Failure to follow the officer(s) commands may result in my criminal arrest and prosecution (720 ILCS 5/31-I).

106. 1. I agree with rule and regulation #9 above.

108. #10. I will not become involved verbally or physically unless the officer’s safety is at risk, or I am specifically directed to do so by a police officer(s). The City of Wheaton and Wheaton Police Department will not be liable for my unauthorized intervention(s).

110. 1. I agree with rule and regulation #10 above.

112. #11. I understand that if I enter any crime scene that such unauthorized entry will subject me to criminal arrest and prosecution (720 ILCS 5/31-I).

114. 1. I agree with rule and regulation #11 above.

116. #12. I understand that equipment assigned to an officer and the vehicle in which I will be riding is for the purpose of aiding the officer in the performance of their official duties only. I will not touch, handle, adjust, or manipulate any of the equipment in the vehicle or that is worn by the officer.

118. 1. I agree with rule and regulation #12 above.

120. #13. Participants must not leave the patrol vehicle unless instructed to do so by an officer(s).

122. 1. I agree with rule and regulation #13 above.

124. #14. When the patrol unit is assigned to a dangerous call, the rider may be dropped off at a safe location and he/she must remain there until the officer or another officer returns to pick him/her up.

126. 1. I agree with rule and regulation #14 above.

128. #15. Participants will provide his/her own transportation to and from the police department.

130. 1. I agree with rule and regulation #15 above.

132. #16. I understand that I must voluntarily submit to a criminal history check to determine my suitability to participate and that approval or denial based upon this criminal history check is within the sole discretion of the Wheaton Police Department. I understand that persons with extensive criminal backgrounds will not be allowed to participate in the Ride-Along Program.

134. 1. I agree with rule and regulation #16 above.

136. #17. Ride-along tours are normally six (6) hours in duration; however, either the officer or the rider may terminate the tour at any time. The on-duty supervisor will be advised of an early termination.

138. 1. I agree with rule and regulation #17 above.

140. #18. Applicants will be notified by a representative of the Wheaton Police Department after filing the written application request form. At that time, the applicant will be scheduled an/or confirmed, or denied.

142. 1. I agree with rule and regulation #18 above.

144. #19. During the Ride-Along, you are strictly a silent observer. You must not tell others what you see or hear during the tour that could be detrimental to the prosecution of any case arising from the officer’s performance of their official duties. You may be called upon to be a witness in a court proceeding and you may be called upon for assistance. The decision for this will rest solely upon the officer to whom you are assigned and the circumstances.

146. 1. I agree with rule and regulation #19 above.

148. #20. Participants shall not converse with any prisoners, suspects, victims, or witnesses, nor shall they participate in any police activity, unless directly requested by officers.

150. 1. I agree with rule and regulation #20 above.

152. #21. All participants agree that they are required by law and the Wheaton Police Department to maintain confidentiality. They must agree not to discuss names of persons involved in police cases or incidents, including information about criminal activity, victim/arrestee identity, family issues, and/or medical conditions of persons associated with a particular call for service. The observer will be considered a confidant of the Police Department and it is essential that all matters pertaining to evidence or statements gathered in investigations be held confidential.

154. 1. I agree with rule and regulation #21 above.

156. #22. Confidential information must not be shared or used for financial gain. Unauthorized disclosure of confidential information may result in criminal prosecution.

158. 1. I agree with rule and regulation #22 above.

160. #23. I understand that any conventional/digital camera, cellular telephone camera (still or video), conventional/digital tape recorder, or any similar electronic recording device(s) are strictly prohibited unless prior written approval is granted by the Chief of Police or the Chief's designee.

162. 1. I agree with rule and regulation #23 above.

164. #24. By signing this form, I certify that the above information is correct, and I agree to abide by the above-listed rules and regulations. I understand that I may be exposed to information of a confidential nature, including but not limited to, information about criminal activity, victims’ identities, family issues, or medical conditions. I understand that I am required by law and expected by the Wheaton Police Department to maintain strict confidentiality of all information.

166. 1. I agree with rule and regulation #24 above.
168. Date:
     Date:
170. Signature of Civilian Ride-Along Participant:*
172. Signature of Guardian/Parent (If under age of 18):

174. RELEASE OF ALL LIABILITIES

     I AM FULLY AWARE THAT POLICE WORK IS INHERENTLY DANGEROUS DUE TO MANY FACTORS, INCLUDING, BUT NOT LIMITED TO, THE POSSIBILITY OF HIGH-SPEED PURSUITS, ARMED SUSPECTS, AND POTENTIAL EMOTIONAL TRAUMA. THIS IS STRICTLY A VOLUNTARY PROGRAM AND I UNDERSTAND THAT MY PARTICIPATION IN THIS ACTIVITY IS FULLY TAKEN WITH KNOWLEDGE OF THE POTENTIAL DANGER INVOLVED AND MY WILLINGNESS TO ASSUME FULL RESPONSIBILITY FOR, AND RISK OF, BODILY INJURY, DEATH, OR PROPERTY DAMAGE DUE TO THE NEGLIGENCE OF THE CITY OR OTHERWISE RESULTING FROM ANY ASPECT OF MY VOLUNTARY PARTICIPATION IN THE WHEATON POLICE DEPARTMENT RIDE-ALONG PROGRAM. 

     The undersigned hereby understands that upon signing this form and entering into a “Police Ride-Along Program” that hazards, above and beyond those which are ordinary, may be present during said “Police Ride-Along Program” because of the mere nature of the police operation. 

     The undersigned hereby releases, remises, and discharges the City of Wheaton, a municipal corporation, its officers, servants, agents, and employees of and from any and all claims, demands, and liabilities to me and on account of any and all injuries, losses, and damages to my person shall have been caused, or may at any time arise as the result of my accompaniment with a police officer from time to time, during his/her tour of duty, the intention hereof being to completely, absolutely and finally release said City of Wheaton and its officers, servants, agents, and employees of and from any and all liability arising wholly or partially from the cause aforesaid.

     For the record, when an emergency call is received by an officer assigned as the driver of the ride-along, the said officer is to exercise proper judgment in determining whether the civilian will be permitted to remain in the squad car. If a question exists, the officer is to give priority consideration to the civilian’s safety, having him/her leave the squad prior to responding to the call, and deciding to have the civilian picked up at a specific location by another unit.

176. Date:
     Date:
178. Signature of Civilian Ride-Along Participant:*
180. Signature of Guardian/Parent (If under age of 18):
Leave This Blank:


182. 1. Receive an email copy of this form.
183. Email address

     This field is not part of the form submission.

184. Submit

* indicates a required field