- Name: Tom Mathers
- Date of Birth: 08/NOV/1998
- Phone number: 554-5069
- Occupation: Junior Mechanic LSC
- Have you ever been convicted of a crime?: Yes
- Have you recently been convicted of a felony crime?: No
Availability:
Nearly all the time.
Why do you wish to go on a Ride-Along with the Los Santos Emergency Medical Services?:
I wish to soon apply for LSEMS, in the meantime I'd like to interact with more of the EMS staff and learn of the daily duties of someone within EMS.
(( Your Timezone Relative to UTC )):
UTC-5:00 (EST)
By signing this form, you agree to the following terms and conditions:
- I agree to the LSEMS conducting background checks to determine my suitability for a ride along.
- I will not bring any weapons.
- I will not interfere with the Emergency Medical Services doing their job.
- I will listen to the Medic In-Charge's instructions at all times, unless it is to assist in their work.
- I will remain in the ambulance and will not communicate with anyone while on scenes with the LSPD or the LSSD.
- I will show I possess common sense.
- The Medic In-Charge can stop the ride-along at any point at their own discretion.
- If I get injured, the LSEMS can not be held responsible, unless gross misconduct led to the injuries.
I, The Applicant; of sound mind and body, voluntarily participates in the Los Santos Emergency Medical Services Ride-Along Program. I understand that there are risk, such as physical, psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability or death, which may occur from participating. Nonetheless, I assume all related risk, whether known or unknown to me. I agree to hold the Los Santos Emergency Medical Services harmless from any and all claims, loss or damage to my person which includes liabilities and cost 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 Rules 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: TOM MATHERS
Date Signed: 24/SEPT/2021
Date Signed: 24/SEPT/2021
