State of Wisconsin Department of Natural Resources




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State of Wisconsin

Department of Natural Resources

dnr.wi.gov

Conservation Warden Ride-Along Request & Agreement


Form 9100-841 (R 5/09) Page of




The purpose of a ride-along is to show the various aspects of a conservation warden's job. The Ride-Along Agreement is an informal agreement between a Conservation Warden and an interested party and explains the terms of the Ride-Along.

In consideration of being permitted to ride in a vehicle owned and operated by the State of Wisconsin or to accompany law enforcement officers of the State of Wisconsin, I agree to the following:

1. I will not interfere with Department officers in the performance of their duties nor will I represent myself as a law enforcement officer or Department employee unless that is in fact the case.

2. I must abide by all reasonable requests of Department officers.

3. I will not touch or use Department equipment, including radios, lights, siren, etc., unless specifically directed by the Department officer.

4. I am acting only as an observer and am not an agent or employee of the Department of Natural Resources.



  1. When approaching a potential law enforcement situation, I will remain in the vehicle unless directed or given permission to do otherwise.

6. I am aware that Department policy prohibits non-Department employees from being passengers in a high speed pursuit and that I may be directed to leave the vehicle if such a pursuit is necessary.

7. I am aware that the work of the law enforcement officers is inherently dangerous and that I may be subjected to the risk of death, personal injury or damage to my property by accompanying a member or members of the law enforcement staff during the performance of their official duties and that I freely, voluntarily and with such knowledge assume such risks arising from or in any way connected with the use of weapons; unlawful acts or forcible resistance by law violators or suspected law violators, assault, riot, breach of the peace, fire, explosions, gas, electrocution or the escape of radioactive substances while accompanying a member or members of the law enforcement staff during performance of their official duties.

8. I hereby waive and release the State of Wisconsin, its agents, employees, personal representatives, and assigns from any and all claims for all damages resulting to myself as a consequence of being transported or being in such vehicle or in the company of such officer and do further covenant and agree to indemnify the State of Wisconsin, its agents, employees, personal representatives, and assigns and to save each of them harmless against any and all loss from all claims which may be made or brought against them as a consequence of the said activity.

Notice: Personally identifiable information collected will be used for program administration and may be provided to requesters as required by Wisconsin's Open Records law [ss. 19.31-19.39, Wis. Stats.].

Name of Ride-Along Applicant

     


Phone

     


Address

     


City, State, ZIP

     


Email Address

     


Date of Birth (mm/dd/yyyy)

     


(See Policy: must be at least 16 years of age, or at least 12 if an immediate family member)

Sponsoring School (if applicable)

     


Date of Ride-along

     


Each ride-along date requires a separate request form.

Time

     


Warden Name (if known)

     


Signature of Ride-Along Applicant

Date Signed

Signature of Parent(s) or Guardian (required if participant is less than 18 years of age)

Date Signed

Why do you want to participate in the ride-along program? (Continue on another sheet if necessary.)

     


Save this document and send in an email to your local conservation warden. Email addresses can be found in the .

Print and sign a copy to bring with you to the ride-along. You are required to bring this signed agreement the day of the ride-along. The ride-along will not take place without a signed agreement.

For Warden Use Only: 



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