I, [your name], age [age], voluntarily request permission to participate in the Fullerton Fire Department's Ride-Along Program ("Ride-Along"). I understand that my participation may involve riding in a Fire Department vehicle and being in close proximity to emergency activities. I understand that I must be in good health to participate in a Ride-Along. I further understand that serious accidents may occur during a Ride-Along, including during transportation, and that participants may be exposed to personal injury, property damage, or death. I hereby agree for myself, my heirs, administrators, executors, and assigns, to assume those risks and release, discharge, and agree not to sue the City of Fullerton, the Fullerton Fire Department, and/or any of its officials or employees ("Fullerton") for any personal injury, property damage, or death arising out of, or in connection with, my participation in a Ride-Along from whatever cause, including the negligence of Fullerton or any other participants in the Ride-Along.

In consideration for being allowed to participate in a Ride-Along, I hereby agree for myself, my heirs, administrators, executors, and assigns, that I shall indemnify, defend, and hold harmless Fullerton from any and all claims, demands, actions, or suits, arising out of, or in connection with, my participation in a Ride-Along.

I also agree not to interfere with any Fire Department employee in the performance of his/her duties and to follow any instructions given to me by Fire employees during a Ride-Along. I understand that failure to do so may result in the immediate termination of my participation. I understand that I shall not take photos or record video while participating in the Ride-Along Program.

I understand that during a Ride-Along I may be exposed to confidential medical information, patient identities, and other protected health information. I agree to keep all such information strictly confidential and to not disclose any patient identities, medical conditions, or details of emergency scenes to any person, whether verbally, in writing, or through any electronic means.

I authorize Fullerton to administer emergency treatment to me in the event of injury, accident, or illness during my participation. I understand that I may be responsible for costs of treatment.

If any provision of this agreement is held to be invalid or unenforceable, the remaining provisions shall continue in full force and effect. This agreement shall be governed by the laws of the State of California, and any disputes arising from this agreement shall be resolved in the courts of Orange County, California.

I HAVE CAREFULLY READ THIS DOCUMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE OF THE POTENTIAL DANGERS IN PARTICIPATING IN A RIDE-ALONG. I AM AWARE THAT THIS DOCUMENT IS A FULL RELEASE OF ALL LIABILITY AND AM SIGNING IT ON MY OWN FREE WILL.