MUPD Request for Ride Along

Requested Date/Time for Ride Along

Do you have an affiliation with Miami

List Your Affiliation

Are you 18 years of age or older?

If the answer is no, please provide your parent/legal guardian information below as the emergency contact.

Emergency Contact Person's Name

Emergency Contact Person's Phone Number

Please list any allergies, medications, and other medical history of the rider. If applicable, please indicate if you would like a specific officer to be assigned to this ride along.

The full details of a ticket, including any appropriate circumstances or supplementary information that may aid in resolving it.

Local Address

By signing below, I do hereby agree and hereby waive any and all rights and privileges which I may have against Miami University and/or any officer of Miami University’s Police Department or any damages or injuries which I may suffer as a result of my privilege to ride, walk, or accompany any officer of the Miami University Police, in the process of discharging the normal duties of their offices. The sole purpose of being with an officer of the Miami University Police is for my benefit and not that of Miami University or any other agency thereof and for that reason I hereby release Miami University and all officers thereof of all claims for injuries I may suffer while with said officer.

Do you agree to the above statement?

I agree

Your name

Your email address

Your phone number

Verification Code

MUPD Request for Ride Along

Other Fields