Personal information
Name: Ailani Momoa
Phone number: 3359145
Occupation: Unemployed.
Have you ever been convicted of a crime?: No
Have you recently been convicted of a felony crime?: No
Name: Ailani Momoa
Phone number: 3359145
Occupation: Unemployed.
Have you ever been convicted of a crime?: No
Have you recently been convicted of a felony crime?: No
Request details
When are you available?:
Anytime.
Why do you wish to go on a ride-along with the Los Santos Emergency Medical Department?:
Hoping to join MD.
((Timezone relative to UTC)): CST
When are you available?:
Anytime.
Why do you wish to go on a ride-along with the Los Santos Emergency Medical Department?:
Hoping to join MD.
((Timezone relative to UTC)): CST
By signing this form, you agree to the following terms and conditions:
- I will not interfere with the EMT doing their job.
- I agree to the LSEMS conducting background checks to determine my suitability for a ride along
- I will listen to the EMT's instructions at all times, unless it is to assist in their work.
- The EMT can stop the ride-along at any point at their own discretion.
- I will not bring any weapons.
- If I get injured, the LSEMS can not be held responsible, unless gross misconduct led to the injuries.
- While on scenes with police involved I will remain in the ambulance and will not communicate with anyone.
- I will show I possess common sense.
Signature: Ailani Momoa
Date Signed: 07/24/2019
Date Signed: 07/24/2019