LOUDOUN COUNTY SHERIFF’S OFFICE
880 Harrison Street, SE
Leesburg, VA 20175
RIDE-ALONG PROGRAM APPLICATION
Ride Along – Please review/sign the areas highlighted in green.
Deputy – Please review/sign the areas highlighted in orange. Upon completion of ride-along, return the ID and application packet to Sgt. Gable.
LOUDOUN COUNTY SHERIFF’S OFFICE
RIDE-ALONG PROGRAM APPLICATION PACKET
Contents:
Ride-Along Program Application (LCSO Form 1.15A)
Ride-Along Program Rules and Regulations (LCSO Form 1.15D)
Waiver of Civil Liability and Indemnification Agreement (LCSO Form 1.15C)
Instructions:
Read the Ride-Along Program Rules and Regulations form prior to completing the Ride-Along Program Application. Once the Application has been completed and signed, you may mail or hand deliver the form to Sgt. Lee Ann Gable, 45299 Research Place #100, Ashburn, VA 20147 or fax it to Sgt. Lee Ann Gable at 703-729-0404. If you under the age of eighteen (18), a parent/guardian must also sign this and all accompanying forms.
Read and sign the Ride-Along Program Rules and Regulations form. This form must be brought with you for your scheduled ride-along and must be signed by the deputy with whom you are assigned to ride. You must have this form in your possession to complete your ride-along.
Read the Waiver of Civil Liability and Indemnification Agreement prior to your assigned ride-along. This form must be brought with you on the date of your scheduled ride-along and must be signed in the presence of the deputy with whom you are assigned to ride. If you are under the age of eighteen (18), your parent/guardian must sign the form.
Questions regarding the Loudoun County Sheriff’s Office Ride-Along Program may be directed to Sgt. Lee Ann Gable at 571-258-3047.
Loudoun County Sheriff’s Office
RIDE-ALONG PROGRAM APPLICATION
You are required to complete this application after reading the Ride-Along Program Rules and Regulations (attached). By signing this application, you acknowledge that you have read, understand and are willing to comply with these rules and regulations. You will need to review the Waiver of Civil Liability and Indemnification Agreement (attached) and will be required to sign the waiver section in the presence of a deputy sheriff when you report for your ride-along. If you are under age 18 years of age, your parent or guardian must cosign this application indicating they too have read, understand and agree with the conditions placed on your participation in this program. Your parent/guardian also needs to sign the waiver section prior to turning the application into the department. Your parent/guardian will be telephoned prior to your ride-along to verify their approval. You will have to sign the waiver section in the presence of a deputy sheriff when you report for your ride-along.
No application will be processed unless all the required information is provided and you have signed the bottom of this page. Once your application has been processed, you will be contacted prior to your requested ride-along date by telephone or by e-mail and informed if your application has been approved. All telephone notifications will be made to the telephone number indicated by you.
This is a voluntary program conducted in the interest of public enlightenment. The Loudoun County Sheriff’s Office reserves the right to limit or exclude any person from participation in this program when it is deemed by the Department that the person’s participation would not be in the best interest of the Sheriff’s Office, of any of its individual members, or the public, or when it might reasonably be construed that a conflict of interest may exist between the applicant and the Sheriff’s Office or its mission. Misleading or false statements made on this application shall be grounds for automatic refusal of any ride-along application.
Full Name: ______
Home Address: ______
Home Phone Number: ( ) ______Work Phone Number: ( ) ______
Email Address: ______
Date of Birth: ______/______/______
Drivers License Number/Social Security Number: ______/______
Occupation: ______If student, name of school: ______
Indicate shift you wish to ride (Please circle choice): Days Evenings Midnights
Indicate Station (Please circle choice): University Station Round Hill Station Dulles South Station
If you have a preference, list the deputy with whom you wish to ride: ______
Reason you request to ride: ______
______
Have you previously ridden with this Department: ______If yes, number of times per year: ______
Have you previously been refused participation in this program? ______If yes, reason for refusal: ___
______
Do you have any medical condition that might affect your ability to participate in the program? ______
If yes, please explain: ______
Have you ever been arrested? ______If yes, please explain: ______
______
Who may we contact in the event of an emergency during your ride-along?
Name: ______Relationship: ______
Address: ______Telephone Number(s): ______
I affirm that the information provided in this application is true and correct to the best of my knowledge and belief. I hereby give consent and authorize the Loudoun County Sheriff’s Office to search their files for any criminal history record and obtain information from other sources to support the data on this application.
Signature: ______Date: _____/_____/_____
Signature of parent/guardian: ______Telephone: ( ) ______
For Persons Under Age 18
LCSO Form 1.15A
09/2006
Loudoun County Sheriff’s Office
RIDE-ALONG PROGRAM RULES AND REGULATIONS
Applicants must meet, at a minimum, one of the following criteria:
Be a representative of a business or civic group;
Be eighteen (18) years of age or older;
Be an applicant for the position of Deputy Sheriff or Explorer Post;
Be sponsored by a Deputy Sheriff;
Have had no participation in the Program within the past twelve (12) months (exceptions apply);
Be employed by Loudoun County in a position that would be facilitated by the knowledge of departmental procedures and functions;
Be a member of the Loudoun County Sheriff’s Office sponsored Citizen Police Academy;
Be a family member of an employee of the Loudoun County Sheriff’s Office;
Demonstrate a special interest for participation that would benefit the Sheriff’s Office, county government, or its citizens; or
Be a college/university student where participation in a ride-along program is a mandatory requirement for course completion/credit.
1. When completing the application, indicate your preference as to which shift you would like: Days (6:00 am to 5:30 pm), Evenings (3:00 pm to 2:30 am), and Midnights (7:30 pm to 7:00 am). Also indicate which substation you prefer: University Station, Dulles South Station, Round Hill Station. On the date of your scheduled ride-along, you must report to the appropriate Sheriff’s Office substation at least fifteen (15) minutes prior to the scheduled time of the program.
2. You must bring your driver’s license or other photo identification with you when you report for your ride-along. Juveniles who report with their parent/guardian do not have to bring such identification, only their parent/guardian needs identification.
3. You are a reflection on the Loudoun County Sheriff’s Office and are expected to dress and act appropriately. Follow all instructions by your assigned deputy during the program. No interference with the performance of the deputy shall be permitted. Inappropriate actions or comments will not be tolerated and will result in the termination of your ride-along. Participants arriving under the influence of any alcoholic beverage or illegal substance will not participate in the program and will be subject to criminal prosecution. Attire is casual business. No shorts, t-shirts, tank tops, jeans or sandals. Men’s shirts must have collars. Shoes are required. Make sure to bring appropriate outerwear based on weather and temperature.
4. The shift supervisor will designate with whom you will ride.
5. What you see and hear during a ride-along is to be treated as confidential. You are not to disclose/repeat any information regarding individuals involved, statements made or actions taken against someone involved in an incident. These items may only be discussed with other deputies if you are asked to disclose this information or testify in court proceedings. Under no circumstances are you to disclose any information about an incident to any media person.
6. The shift supervisor or deputy may terminate your ride-along at any time if, in their opinion, your continued participation presents an undue risk, or your conduct is such that your continued participation is not in the best interest of the department. A complete report will be forwarded to the Ride-Along Program Coordinator of the reasons for termination.
7. You are prohibited from carrying with you during the ride-along any flashlight, camera, any type of radio, video recorder, tape recorder or player, binoculars, or any similar device. Participants, including holders of concealed carry permits are prohibited from carrying any weapons, personal chemical protection device, or restraining device of any kind. Exceptions will be made for sworn patrol certified law enforcement officials from this state, or federal officers. The carrying of concealed weapons by sworn patrol certified law enforcement officials from this state and by federal officers will be governed by state code. The law enforcement or federal officers will be identified by clearly displaying their badge of authority.
8. Participants are observers. You will not exit the police vehicle during any police activity unless directed to do so by a deputy sheriff. You will refrain from direct involvement in law enforcement functions or conversation with violators, suspects, arrestees, witnesses, complainants, or other members of the public encountered during the course of the official duties of the deputy sheriff which whom you are riding. If requested, you must aid/assist the deputy in accordance with the Code of Virginia , Section 18.2-463 which states:
“Refusal to aid officer in execution of his office.
If any person on being required by any sheriff or other officer refuse or neglect to assist him: (1) in the execution of his office in a criminal case, (2) in the preservation of the peace, (3) in the apprehending or securing of any person for a breach of the peace, or (4) in any case of escape or rescue, he shall be guilty of a Class 2 misdemeanor.”
You will not be requested to assist if the officer feels you will be at risk of great bodily harm. If you are not requested to assist, upon finding safety, you will notify the Loudoun County Sheriff’s Office Emergency Communications Center by use of 911 or the vehicle radio system. Prior to your ride-along, the deputy will instruct you on how to use the radio in an emergency.
9. The deputy assigned the ride-along participant is responsible for their safety and conduct. The officer shall explain what action the participant is expected to take in the event of an emergency. At the deputy’s discretion, the participant may be required to exit the police vehicle prior to responding on selected emergencies. In accordance with Department policy, deputies participating in the ride-along program shall not engage in any pursuit with a civilian passenger in the vehicle. The participant shall wear their seatbelt in accordance with state law.
10. All ride-along participants shall wear, in a visible location, identification which is approved and provided by the Department. You are to identify yourself as an authorized citizen observer or a ride-along when asked to do so.
11. Participants shall not be permitted to remain with prisoners in the absence of deputies.
12. Ride-along participants are prohibited from using any type of tobacco product during the ride-along.
I, ______, have read and agree to the rules and guidelines set forth for the participation in the Loudoun County Sheriff’s Office Ride-Along Program. I am fully aware of the possible consequences for violation of these rules and guidelines.
Ride-Along Participant Date / Ride-Along Deputy DateLCSO Form 1.15D
09/2006
Loudoun County Sheriff’s Office
WAIVER OF CIVIL LIABILITY AND INDEMNIFICATION AGREEMENT
In consideration of the Loudoun County Sheriff’s Office of Leesburg, Virginia granting me permission to accompany a member of the Sheriff’s Office as an observer in the Ride-Along Program, I hereby waive any and all rights and claims of liability for damages, losses, personal injuries or death which I might suffer, sustain or cause while participating in the Ride-Along Program. I further waive any and all claims, demands, actions, damages, or suits at law or equity of whatever nature which I have or may hereafter acquire against the County of Loudoun, its Sheriff’s Office, its elected officials, agents or employees, as a result of my voluntary participation in the Ride-Along Program; and I hereby hold harmless such persons and entities. In the event that a demand or claim, whether groundless or otherwise, is made against the entities and/or persons set forth herein, I agree to indemnify those persons and/or entities for all damages, attorney fees and costs incurred in defending said demand or claim.
I further agree to comply with all rules and regulations of the Ride-Along Program and any instructions or orders issued by members of the Loudoun County Sheriff’s Office in connection with the Ride-Along Program. I certify that I am aware of the potential risk involved in accompanying a deputy sheriff during the performance of his/her duties.
* * * DO NOT SIGN THIS WAIVER NOW * * *
You will be required to sign the waiver in the presence of a deputy sheriff when you report for your ride-along. Please ensure you have your drivers license or other form of photo identification with you when you report for your ride-along.
I hereby acknowledge that I fully understand the consequences of this waiver and that it is a voluntary and intelligent act on my part.
______/_____/_____
Signature Printed Name Date
Identification verified and signature witnessed by: ______
Deputy Sheriff
IF APPLICANT IS UNDER 18 YEARS OF AGE
THE BELOW SECTION MUST BE COMPLETED PRIOR TO SUBMITTING APPLICATION
I am the parent/guardian of ______who is requesting to participate in the Ride-Along Program of the Loudoun County Sheriff’s Office. I hereby give my permission for this ride-along and agree to all of the terms set forth in the Ride-Along Application.