Application must be filled out prior to participation. Participation may be denied unless all necessary paperwork is completely filled out and signed.
APPLICANT INFORMATION
1. FULL NAME
- Lucas Gray
2. DATE OF BIRTH
- 28/AUG/2003
3. GENDER
- [X] MALE
[] FEMALE
4. PHONE NUMBER
- 700-1477
5. HOME ADDRESS
- Western Star Hotel, Room 112, Montgomery
6. ADDRESS OF EMPLOYMENT/SCHOOL (IF APPLICABLE)
- N/A
7. DATE(S) REQUESTED TO RIDE-ALONG
- 15/JUN/2025
16/JUN/2025
17/JUN/2025
8. HAVE YOU EVER BEEN ARRESTED? IF YES, LIST OFFENSE(S)
- N/A
By signing this form the applicant authorizes a criminal records check prior to the requested ride-along.
AGREEMENT ASSUMING RISK OF INJURY OR DAMAGE, WAIVER, RELEASE OF CLAIMS INDEMNITY AGREEMENT
WHEREAS, I, GRAY LUCAS (being) over the age of 18 and not being a member of the Red County Sheriff’s Department have made a voluntary request to ride as a guest in a vehicle assigned to the Red County Sheriff’s Department and to accompany a member or members of the Sheriff’s Department during the performance of their official duties.
WHEREAS, the Red County Sheriff’s Department is willing to allow me to ride as a guest [in] a vehicle, vessel or other county asset assigned to the Red County Sheriff’s Department and to accompany a member or members of the department during the performance of their duties on the following conditions:
NOW, THEREFORE, in consideration of the permission given to me to ride [in] a vehicle or vessel, and/or in, on, or upon any other county owned asset assigned to the Red County Sheriff’s Department and to accompany a member or members of said department during the performance of their official duties, I do hereby agree:
1. That I am aware that the work of the Red County Sheriff’s Department is inherently dangerous and that I may be subjected to the risk of death or personal injury or damage to my property by accompanying a member or members of the Red County Sheriff’s Department during the performance of their official duties and that I freely, voluntarily, and with such knowledge assume the risk of death, personal injury, or property damage arising from or in any way connected with use of weapons; unlawful acts or forcible resistance by law violators or suspected law violators, assault, riot, breach of peace, fire, explosion, gas, electrocution or the escape of radioactive substances while accompanying a member or members of the Red County Sheriff’s Department during the performance of their official duties.
2. That the County of Red, the Sheriff, his sureties, all members of the Red County Sheriff’s Department, their sureties, and each of them, shall not be responsible or liable for any injury, damage, loss, or expense, either to me or my property, incurred while riding in any vehicle or on a horse assigned to the Red County Sheriff’s Department or while accompanying any member or members of said department during the performance of their official duties and resulting from any negligent act or omission on the part of any member of the Red County Sheriff’s Department.
I hereby represent that I have carefully read and understand the contents of this document and sign the same of my own free will.
DATE: 14/JUN/2025
SIGNATURE: LUCAS GRAY
