REQUESTEE DETAILS
Full Name Jack Falkenlove
Date of Birth: 28/FEB/1999
Phone Number: 462-2791
Have you ever been convicted of a crime?: Yes
Date of Birth: 28/FEB/1999
Phone Number: 462-2791
Have you ever been convicted of a crime?: Yes
REQUEST DETAILS
Availability
Whenever in the evenings 6pm to 3 am MST/MDT.
Why do you wish to go on a ride-along with the Los Santos Emergency Medical Services?
I have a lot of friends who are in the LSEMS and I also have an interest in maybe one day joining the ranks of EMS saving the lives of the state.
Whenever in the evenings 6pm to 3 am MST/MDT.
Why do you wish to go on a ride-along with the Los Santos Emergency Medical Services?
I have a lot of friends who are in the LSEMS and I also have an interest in maybe one day joining the ranks of EMS saving the lives of the state.
RELEASE & WAIVER
I, The Applicant; of sound mind and body, voluntarily participate in the Los Santos Emergency Medical Services Ride-Along Program. I understand that there are risks, such as physical, or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability, or death, which may occur from participating. Nonetheless, I assume all related risks, whether known or unknown to me.
I agree to hold the Los Santos Emergency Medical Services harmless from any and all claims, losses, or damage to my person which includes liabilities and costs as a result of my participation in their program.
I understand that the Los Santos Emergency Medical Services has the right to waive my right to their Ride-Along Program for any reason and at any time, especially if I were to violate the Regulations and Requirements they have set. With the following, I sign this application knowing that I am to adhere to the Terms and Conditions set by the Los Santos Emergency Medical Services.
I agree to hold the Los Santos Emergency Medical Services harmless from any and all claims, losses, or damage to my person which includes liabilities and costs as a result of my participation in their program.
I understand that the Los Santos Emergency Medical Services has the right to waive my right to their Ride-Along Program for any reason and at any time, especially if I were to violate the Regulations and Requirements they have set. With the following, I sign this application knowing that I am to adhere to the Terms and Conditions set by the Los Santos Emergency Medical Services.
Signature: Jack Falkenlove
Date Signed: 20/APR/2025
Date Signed: 20/APR/2025





